The Relationship Between Enlarged Perivascular Spaces And The Imaging Markers Of Cerebrovascular Disease And Functional Outcome In Acute Ischemic Stroke Patients

Background and PurposeEnlarged perivascular spaces as one of the imaging markers of cerebrovascular disease are often seen on T2-weighted brain magnetic resonance imaging in the basal ganglia and centrum semiovale.At present,some studies suggest that enlarged perivascular spaces in the basal ganglia are independently associated with intracranial atherosclerosis in the elderly,while others have shown that enlarged perivascular spaces is the image marker of cerebral small vascular disease.However,whether extent of Enlarged Perivascular Spaces is associate with other neuroimaging markers of cerebrovascular disease is still unknown.Although previous studies have suggested that the enlarged perivascular space can aggravate the bad prognosis of patients with vascular dementia,but the relationship with the poor prognosis of patients with acute cerebral infarction is not clear,so it is becoming more and more concerned.The aim of this study was not only to explore the relationship with the extent of Enlarged Perivascular Spaces and the imaging markers of cerebrovascular disease,but also the correlation with functional outcome in patients with acute ischemic stroke.Methods1288 acute cerebral infarction patients who meet the including criteria were included in this research in the 1^st.Affiliated Hospital of Zhengzhou University,from January 2014 to December 2016.Their MRI examination were underwent during the hospitalization.Patients were divided into the mild to moderate group and severe group according to the EPVS score?0-2score and 3-4 score separately?and different locations.For assessment of cerebral small vessel disease burden,we visually rated lacunes and evaluated the scores of white matter hyperintensities?WMH?according to the Fzaekas score rating.We used intracranial atherosclerotic stenosis?ICAS?to assess arterial atherosclerosis.The modified Rankin Scale score?mRS?at the 3-month,6-month,1-year follow-up was used to evaluate the functional outcome,respectively,with the mRS score>2 defining poor long-term functional outcome.The association between EPVS between and lacunes,ICAS,WMH and mRS score were investigated by using multivariate logistic regression analyses.Results1288 patients were included to this study according to the inclusion criteria.Logistic regression analysis showed that after adjustment for the other risk factors,DWMH?P<0.001??CSO-EPVS?P<0.001??PWMH?P<0.001?and lacunes?P<0.001?are still associated with the extent of BG-EPVS.The severity of BG-EPVS?P<0.001?and PWMH?P=0.002?which were assessed by Fazekas are significantly associated with CSO-EPVS.Only the severity of CSO-EPVS?P=0.01?was related to short-term functional outcome in patients with AIS.Conclusions1.Enlarged perivascular space isn't associated with ICAS,which as a imaging markers of intracranial atherosclerosis.2.The prevalence and severity of EPVS,especially the BG-EPVS,is significantly correlated with the imaging markers of small vessel disease.3.Only the severity of CSO-EPVS was related to the poorer short-term functional outcome in patients with AIS.