MRI上血管周围间隙与血管性危险因子及脑梗死发病的相关性

目的探讨头颅MRI上血管周围间隙与血管性危险因子及脑梗死发病的相关性。资料与方法将脑内血管周围间隙按照不同解剖部位和表现型分成17型,分析不同部位和类型血管周围间隙与血管性危险因子的关联,及其与脑梗死发病的关系。结果 MRI上直径3mm以下的血管周围间隙表现型最多的是Ⅱ型(T1WI低信号,T2WI高信号,FLAIR等信号)和Ⅲ型(T1WI低信号,T2WI高信号,FLAIR低信号);6个以上多发者最常见的是基底节上2/3的Ⅱ型。年龄与基底节上2/3多发的Ⅱ型、Ⅲ型血管周围间隙相关(P<0.01);基底节(上2/3和下1/3合并后)多发的Ⅱ型血管周围间隙与收缩压有关,其中基底节上2/3多发的Ⅱ型血管周围间隙与糖尿病和高血压病相关;基底节(上2/3和下1/3合并后)Ⅲ型血管周围间隙与糖尿病和空腹血糖有关。多发的皮质下白质Ⅱ型和海马部的血管周围间隙也与血管性危险因子相关。频度高的前穿质部位的血管周围间隙与血管性危险因子无关。基底节部位尤其是上2/3多发的Ⅱ型与脑梗死发病相关。结论不同部位和类型的血管周围间隙分别与不同的脑血管病危险因子相关,与脑梗死发病相关,是脑梗死发病的预知因子。

Correlation of VRS on the Brain MRI with Vascular Risk Factors and the Prevalence of Brain Infarction

Purpose To explore the correlation of cerebral virchow robin spaces (VRS) on brain MRI with vascular risk factors and the prevalence of brain infarction. Materials and Methods VRS were categorized into 17 subtypes according to different types and anatomical localizations. The correlation of different subtypes VRS with vascular risk factors and the incidence of cerebral infarction was analyzed. Results The most common VRS less than 3 mm on the MRI were type Ⅱ and Ⅲ . Multiple VRS more than 6 was more frequently observed as type Ⅱ in the upper part of the basal ganglia. Type Ⅱ and type Ⅲ VRS in the upper basal ganglia were strongly associated with age (P <0.01); multiple VRS of type Ⅱ in the upper part of the basal ganglia were significantly correlated with diabetes and hypertension. In the whole basal ganglia, type Ⅱ VRS was correlated with systolic blood pressure. Type Ⅲ VRS was associated with diabetes and fasting blood glucose. VRS in the subcortex and the hippo were also correlated with vascular risk factors. VRS of the anterior perforated substance did not correlate with any of the risk factors. Type Ⅱ in the basal ganglia, particularly in the upper part of basal ganglia, had strong relationship with brain infarction. Conclusion VRS of different subtypes and locations correlate with brain infarction and various vascular risk factors, which should be considered as a predictive factor of brain infarction.