Imaging Features Of Intracranial Enlarged Perivascular Space In Patients With Neuromyelitis Optica Spectrum Disorders And Idiopathic Acute Transverse Myelitis

Objective:To analyze the differences in imaging features of enlarged perivascular space(EPVS)in the brain between patients with neuromyelitis optica spectrum disorders(NMOSD)and idiopathic acute transverse myelitis(IATM).To explore the role of intracranial EPVS in the imaging differential diagnosis of NMOSD and IATM.Methods:A total of 30 patients with NMOSD and 22 patients with IATM who were diagnosed in Shanxi Provincial People’s Hospital from January 2018 to December 2021 were enrolled in this study.31 healthy subjects matched for age and sex in the same period were enrolled in this study.On the premise of accurately identifying EPVS,the diameters of different forms of EPVS in the centrum semiovale and basal ganglia of each group were measured on T2 WI sequence,the number of EPVS was counted and Potter visual semi-quantitative score was performed.The scores of the two levels were added as the total score.The differences in the diameters and scores of intracranial EPVS in the centrum semiovale and basal ganglia and the total scores of the three groups were compared.The relationship between EPVS score,diameter and age in different regions of healthy controls was also analyzed.Results:1.In the semiovale center EPVS score,the score of the NMOSD group [2(2,3)points] was higher than the score of the IATM group [1(1,2)points](P<0.05),and the score of the healthy control group [1(1,2)points](P<0.05);in the EPVS score of the basal ganglia,the score of the NMOSD group [2(1,2)points] was higher than that of the IATM group [1(1,1.25)points](P<0.05),The score of the healthy control group was[1(1,1)points](P<0.05);in the total score of EPVS,the score of the NMOSD group [4(3,5)points] was higher than that of the IATM group [2.5(2,3)points ](P<0.05),the score of the healthy control group was [2(2,3)points](P<0.05);there was no statistical difference between the IATM group and the healthy control group in the center of the semiovale,the basal ganglia and the total EPVS score.academic significance(P>0.05).2.The diameters of EPVS in the centrum semiovale and basal ganglia in the NMOSD group were [1.210(1.180,1.300)mm] and [1.520(1.400,1.725)mm],respectively;the diameters of EPVS in the centrum semiovale and basal ganglia in the IATM group were [1.200(1.075,1.300)mm] and [1.500(1.375,1.708)mm],respectively;the diameters of EPVS in the centrum semiovale and basal ganglia in the healthy control group were [1.300(1.200,1.400)mm] and [1.500(1.300,1.800)mm],respectively,and there were no significant differences in the diameters of EPVS in different regions among the three groups(P>0.05).3.Correlation analysis showed that the EPVS score of centrum semiovale was positively correlated with age in healthy controls(r = 0.371,P<0.05).Conclusion:The grading scores of intracranial centrum semiovale,basal ganglia and total EPVS in patients with NMOSD were significantly higher than those in patients with IATM,and intracranial EPVS can provide imaging auxiliary diagnostic basis for the differential diagnosis of patients with NMOSD and patients with IATM.