Enlarged perivascular space and its clinical significance in patients with cerebral small vessd disease

Abstract

Objective To investigate the enlarged perivascular space （EPVS） and its clinical sigtificance in patients with cerebral small vessel disease （CSVD）. Methods One hundred seventy-four patients with CSVD and 86 patients without CSVD admitted to Jinling Hospital, Clinical School of Nanjing University School of Medicine from October 2011 to February 2012 were recruited. All patients underwent cranial MRI examination （including diffusion-weighted imaging and fluid attenuated inversion recovery sequences）. The numbers of EPVS and anatomic distribution in all the subjects of both groups were analyzed. The receiver operator characteristic （ROC） curve was used to investigate its diagnostic critical value of anatomic distribution. Results Multivariate logistic regression analysis showed that EPVS in basal ganglia region （odds ratio [OR] 1. 491, 95% confidence interval [CI] 1. 165 - 1. 909; P =0. 002） and EPVS in centrum semiovale （OR 1. 279, 95% CI 1. 022 - 1. 601; P=0. 032） were independently associated with CSVD. EPVS in the basal ganglia region and the centrtun semiovale in patients with CSVD was signficantly more than that in patients with non-CSVD （all P 〈0. 001）. Its corresponding diagnosis cut-offpoints of CSVD were 4 and 6 respectively. The area under the ROC curve and the diagnostic sensitivity and specificity were 0. 859, 72. 4%, 93.0% and 0. 808, 65.5%, 95. 3%, respectively. Conclusions EPVS contributes to the diagnosis of CSVD. When using EPVS to diagnose CSVD, the anatomical sites need to be distinguished and establish appropriate diagnostic critical value. Key words: Cerebrovascular Disorders; Brain Infarction; Cerebral Arteries; Magaetic ResonanceImaging; Microcirculation; Dilatation, Pathologic