MRI-visible perivascular spaces in cerebral amyloid angiopathy and hypertensive arteriopathy

被引：248

作者：

Charidimou, Andreas ^{[1
]}

Boulouis, Gregoire ^{[1
,2
]}

Pasi, Marco ^{[1
]}

Auriel, Eitan ^{[1
]}

van Etten, Ellis S. ^{[1
]}

Haley, Kellen ^{[1
]}

Ayres, Alison ^{[1
]}

Schwab, Kristin M. ^{[1
]}

Martinez-Ramirez, Sergi ^{[1
]}

Goldstein, Joshua N. ^{[3
]}

Rosand, Jonathan ^{[3
]}

Viswanathan, Anand ^{[1
]}

Greenberg, Steven M. ^{[1
]}

Gurol, M. Edip ^{[1
]}

机构：

[1] Harvard Med Sch, Hemorrhag Stroke Res Program, Massachusetts Gen Hosp, Dept Neurol,Stroke Res Ctr, Boston, MA 02115 USA

[2] Univ Paris 05, Ctr Hosp St Anne, INSERM, UMR 894,Dept Neuroradiol, Paris, France

[3] Harvard Med Sch, Massachusetts Gen Hosp, Div Neurocrit Care & Emergency Neurol, Boston, MA USA

来源：

NEUROLOGY | 2017年 / 88卷 / 12期

关键词：

SMALL VESSEL DISEASE; CORTICAL SUPERFICIAL SIDEROSIS; VIRCHOW-ROBIN SPACES; INTRACEREBRAL HEMORRHAGE; PREVALENCE; PATHOLOGY; INSIGHTS; MARKERS; LOBAR;

D O I：

10.1212/WNL.0000000000003746

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

Objective: To assess MRI-visible enlarged perivascular spaces (EPVS) burden and different topographical patterns (in the centrum semiovale [CSO] and basal ganglia [BG]) in 2 common microangiopathies: cerebral amyloid angiopathy (CAA) and hypertensive arteriopathy (HA). Methods: Consecutive patients with spontaneous intracerebral hemorrhage (ICH) from a prospective MRI cohort were included. Small vessel disease MRI markers, including cerebral microbleeds (CMBs), cortical superficial siderosis (cSS), and white matter hyperintensities (WMH), were rated. CSO-EPVS/BG-EPVS were assessed on a validated 4-point visual rating scale (0 = no EPVS, 1 < 10, 2 = 11-20, 3 = 21-40, and 4 > 40 EPVS). We tested associations of predefined highdegree (score > 2) CSO-EPVS and BG-EPVS with other MRI markers in multivariable logistic regression. We subsequently evaluated associations with CSO-EPVS predominance ( i. e.,CSO-EPVS. BG-EPVS) and BG-EPVS predominance pattern ( i. e., BG-EPVS. CSO-EPVS) in adjusted multinomial logistic regression ( reference group, BG-EPVS= CSO-EPVS). Results: We included 315 patients with CAA-ICH and 137 with HA-ICH. High-degree CSO-EPVS prevalence was greater in CAA-related ICH vs HA-related ICH (43.8% vs 17.5%, p < 0.001). In multivariable logistic regression, high-degree CSO- EPVS was associated with lobar CMB (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.10-1.61, p = 0.003) and cSS (OR 2.08, 95% CI 1.30-3.32, p = 0.002). Deep CMBs (OR 2.85, 95% CI 1.75-4.64, p, 0.0001) and higher WMH volume ( OR 1.02, 95% CI 1.01-1.04, p = 0.010) were predictors of high-degree BG-EPVS. A CSO- EPVS-predominant pattern was more common in CAA-ICH than in HA-ICH (75.9% vs 39.4%, respectively, p < 0001). CSO- PVS predominance was associated with lobar CMB burden and cSS, while BG-EPVS predominance was associated with HA-ICH and WMH volumes. Conclusions: Different patterns ofMRI-visible EPVS provide insights into the dominant underlying microangiopathy type in patients with spontaneous ICH.

引用

页码：1157 / 1164

页数：8

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