进行性核上性麻痹患者扩大的血管周围间隙的影像学分析

Imaging study of enlarged perivascular space in patients with progressive supranuclear palsy

目的:探讨进行性核上性麻痹(PSP)患者扩大的血管周围间隙(EPVS)的影像学特点及临床意义。方法:回顾性观察9名PSP患者、23名帕金森病(PD)患者及25名健康对照者的3.0T头MRI,在T2WI上分别计数半卵圆中心、基底节区及中脑的EPVS,分析各组不同部位EPVS的差异,并分析EPVS评分与Hoehn and Yahr(H&Y)分级和MMSE评分之间的相关性。结果:在半卵圆中心和基底节区层面,PSP组EPVS评分高于PD组和对照组(P<0.05)。PSP组患者H&Y分级与半卵圆中心(r_(S)=0.415,P=0.018)和基底节区(r_(S)=0.374,P=0.035)EPVS评分呈正相关;MMSE评分与半卵圆中心(r_(S)=-0.379,P=0.004)和基底节区(r_(S)=-0.336,P=0.011)EPVS评分呈负相关。结论:PSP患者的EPVS扩大更严重,并且与运动障碍和认知障碍相关,这可能成为PSP影像诊断及病程评估的一项客观指标。

Aim:To study the imaging features and clinical significance of enlarged perivascular space(EPVS)in patients with progressive supranuclear palsy(PSP).Methods:Head magnetic resonance imaging(MRI)data of 57 subjects were analyzed retrospectively,including 9 patients with PSP,23 patients with Parkinson′s disease(PD)and 25 healthy controls(HC).EPVS in the centrum semiovale,basal ganglia and midbrain was measured on T2WI.The correlations of EPVS score with Hoehn and Yahr(H&Y)stage and MMSE score.Results:In centrum semiovale area,the EPVS score of PSP group was higher than that of PD group and control group;in basal ganglia area,the EPVS score of PSP group was higher than that of PD group and control group(P<0.05).H&Y stage was positively correlated with the EPVS score of centrum semiovale(r_(S)=0.415,P=0.018)and basal ganglia(r_(S)=0.374,P=0.035)in the case group.MMSE score was negatively correlated with the EPVS score of centrum semiovale(r_(S)=-0.379,P=0.004)and basal ganglia(r_(S)=-0.336,P=0.011).Conclusion:The degree of dilatation of EPVS is more severe in PSP patients and is associated with movement disorder and cognitive impairment,which may be an objective indicator for imaging diagnosis and disease course assessment of PSP.