脑微出血灶与脑扩大的血管周围间隙相关性

ASSOCIATION BETWEEN CEREBRAL MICROBLEEDS AND ENLARGED PERIVASCULAR SPACES

目的应用磁共振技术研究脑血管周围间隙与脑微出血灶之间的相关性。方法随机选取行颅脑常规磁共振MR序列(包括T_1WI、T_2WI、Flair及DWI序列)、SWI序列扫描脑血管病病人242例,分析血管周围间隙、微出血灶的位置、大小以及两者之间关系。结果脑微出血、扩大的血管周围间隙发病率均随着年龄的增长而增加。242例病人中,共有脑扩大的血管周围间隙79例(164枚),分布于基底核下前联合区90枚(54.9%),半卵圆中心47枚(28.7%),脑叶23枚(14.0%),小脑半球3枚(1.8%),脑干1枚(0.6%);微出血灶184例(1 524枚),平均长径(2.65±2.81)mm,分布于脑深部白质与灰质核团区112例,幕下区102例,皮质-皮质下区129例。血管周围间隙病人中微出血灶发生率38.5%,脑扩大的血管周围间隙与微出血灶呈正相关(OR=3.926,95%CI=2.206~10.950,P<0.01)。结论脑微出血与脑扩大的血管周围间隙具有正相关性。

Objective To explore the association between cerebral microbleeds （CMBs） and enlarged perivascular spaces （EPVS） based on magnetic resonance imaging （MRI）. Methods We randomly selected 242 patients with cerebrovascular di sease who had undergone brain MRI, including T1WI, T2WI, Flair, DWI, and SWI. The MRI features of CMBs and EPVS （loca- tion/size/number） were analyzed to determine their association. Results The incidence of CMBs and EPVS increased with age. Among the 242 patients, 164 EPVS lesions were detected in 79 patients, with 90 lesions （54.9 %） in the basal ganglia region, 47 lesions （28.7%） in the centrum ovale majus, 23 lesions （14.0%） in brain lobes, 3 lesions （1.8%） in the cerebellar hemisphere, and 1 lesion （0.6%） in the brainstem~ 1 524 CMBs were detected in 184 patients, with a mean diameter of （2.65±2.81） mm, and there were 112 lesions in deep white and grey matter in the brain, 102 lesions in the infratentorial region, and 129 lesions in the cortical or subcortical region. CMBs occurred in 38.5% of patients with EPVS, and there was a positive association between CMBs and EPVS （OR：3.926,95%CI：2.206--10.950,P〈0.01）. Conclusion There is a positive association between the CMBs and EPVS.