Sugai Yasuhiro, Niino Kazuho, Shibata Akiko, Hiraka Toshitada, Kobayashi Atsunori, Suzuki Keisuke, Iseki Chifumi, Ohta Yasuyuki, Kanoto Masafumi
Division of Diagnostic Radiology, Department of Radiology, Yamagata University Faculty of Medicine, Japan.
Division of Diagnostic Radiology, Department of Radiology, Yamagata University Faculty of Medicine, Japan.
Eur J Radiol. 2023 May;162:110792. doi: 10.1016/j.ejrad.2023.110792. Epub 2023 Mar 21.
We aimed to investigate the association between perivascular space (PVS) visible on MRI and brain atrophy or morphological change using quantitative indexes.
This population-based cohort study included 216 older participants. The PVS in basal ganglia (BG-PVS) and cerebral white matter (WM-PVS) was evaluated using a four-point visual rating scale. We segmented brain parenchyma and CSF, and calculated the CSF/intracranial volume ratio, which represents atrophic change. WM lesions were classified using the Fazekas scale. We introduced a new category "idiopathic normal pressure hydrocephalus (iNPH)-like conformation", which was based on two quantitative indexes: Evans index and callosal angle. The association between PVS grade and demographic or morphological factors was evaluated.
A stepwise increase in the CSF/intracranial volume ratio with BG-PVS grade progression and a stepwise decrease with WM-PVS grade progression were observed. A higher CSF/intracranial volume ratio was significantly related to a higher BG-PVS grade in a univariate analysis, but this significance disappeared in a multivariate analysis. The iNPH-like group was significantly related to a lower WM-PVS grade in a univariate analysis, and this significance remained in a multivariate analysis.
The association between BG-PVS enlargement and atrophic changes was verified. On the contrary, WM-PVS showed a different trend, and a lower WM-PVS grade was associated with an iNPH-like conformation. This result implies that the less-visible WM-PVS on imaging as well as BG-PVS enlargement would reflect abnormal brain change.
我们旨在使用定量指标研究MRI上可见的血管周围间隙（PVS）与脑萎缩或形态学改变之间的关联。
这项基于人群的队列研究纳入了216名老年参与者。使用四点视觉评分量表评估基底节区的PVS（BG-PVS）和脑白质的PVS（WM-PVS）。我们对脑实质和脑脊液进行分割，并计算代表萎缩变化的脑脊液/颅内体积比。使用Fazekas量表对脑白质病变进行分类。我们引入了一个新的类别“特发性正常压力脑积水（iNPH）样形态”，其基于两个定量指标：Evans指数和胼胝体角。评估PVS分级与人口统计学或形态学因素之间的关联。
观察到随着BG-PVS分级进展脑脊液/颅内体积比逐步增加，随着WM-PVS分级进展逐步降低。在单变量分析中，较高的脑脊液/颅内体积比与较高的BG-PVS分级显著相关，但在多变量分析中这种显著性消失。在单变量分析中，iNPH样组与较低的WM-PVS分级显著相关，并且在多变量分析中这种显著性仍然存在。
证实了BG-PVS扩大与萎缩性变化之间的关联。相反，WM-PVS呈现出不同的趋势，较低的WM-PVS分级与iNPH样形态相关。这一结果表明，成像上不太明显的WM-PVS以及BG-PVS扩大都将反映脑的异常变化。
