脑血管周围间隙扩大的病理生理机制及临床意义的研究进展

Research progress on pathophysiological mechanism and clinical significance of the enlarged perivascular spaces

脑血管周围间隙扩大(enlarged perivascular spaces,EPVS)是指围绕在脑小血管周围充满液体的间隙直径扩大,随着对脑小血管病发病机制认识的不断提高,EPVS被认为是脑小血管病的一种早期影像学标志,但目前其病理生理机制尚未明确,可能与血管搏动、呼吸运动、睡眠觉醒周期、脑部淋巴系统和水通道蛋白-4有关。越来越多的证据表明,EPVS对认知功能障碍、抑郁症有影响。本文就脑EPVS的解剖特点、影像学评估、病理生理机制及其与认知功能障碍和抑郁症的关系进行综述。

Enlarged perivascular spaces(EPVS)referred to the enlargement of the diameter of the spaces filled with fluid around the small blood vessels in the brain;with the understanding of cerebral small vessel disease pathogenesis,now it is thought as a kind of early imaging sign of cerebral small vessel disease.But its pathophysiological mechanism is still unclear,which may be associated with vascular pulsation,respiratory movement,sleep-wake cycle,brain glymphatic dysfunction and aquaporin 4.An increasing number of evidences suggest that EPVS has an impact on cognitive impairment and depression.This article reviews the anatomic features,imaging evaluation,pathophysiological mechanisms of EPVS and its relationship between cognitive impairment and depression.