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Deprecated: Implicit conversion from float 231.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Neurology 2017 ; 88 (12): 1157-64 Nephropedia Template TP
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MRI-visible perivascular spaces in cerebral amyloid angiopathy and hypertensive arteriopathy #MMPMID28228568
Charidimou A; Boulouis G; Pasi M; Auriel E; van Etten ES; Haley K; Ayres A; Schwab KM; Martinez-Ramirez S; Goldstein JN; Rosand J; Viswanathan A; Greenberg SM; Gurol ME
Neurology 2017[Mar]; 88 (12): 1157-64 PMID28228568show ga
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 high-degree (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 < 0.0001). 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 of MRI-visible EPVS provide insights into the dominant underlying microangiopathy type in patients with spontaneous ICH.
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Neurology 2017 ; 88 (12): 1157-64
