Objective: To investigate the prevalence on imaging, topographic distribution and risk factors of perivascular space (PVS) in community population. Methods: This study was based on the population of Shunyi Study in China from June 2013 to September 2016. One thousand two hundred and thirty-two stroke free participants older than 35 years, who completed cerebral MRI, were included. Cardiovascular risk factors were assessed by interview, physical examination and blood sample tests. PVS were evaluated on high-resolution 3-dimensional-T1WI, T2WI and FLAIR sequences. On T1WI, PVS were detected according to 3D imaging criteria. The number and anatomic location of large PVS (≥3 mm) were recorded. And severity of PVS was then semiquantitatively graded in both white matter (WM) and basal ganglia (BG). Associations between risk factors and PVS were analyzed by multinominal Logistic regression models and adjusted for age, gender and relevant confounders. Results: Perivascular spaces were observed in the BG or WM in every subject, aged (55±10) years and 37.3% male. Large PVS were detected in 19.0% (460/1 232) of participants. Severity of PVS was found to be strongly associated with age in both basal ganglia (severe versus mild: OR=1.81; 95%CI 1.45-2.27, P<0.01) and white matter (OR=1.39; 95%CI 1.13-1.71, P<0.01), and the proportion of subjects with hypercholesterolemia decreased with the severity of PVS in BG (OR=0.58, P=0.01) . The present of large PVS was found to be associated with age(present versus absent: OR=1.03, 95%CI 1.02-1.05, P<0.01) and ApoE ε4 carrier genotype(OR=1.53, 95%CI 1.01-2.23, P=0.04). Conclusions: Perivascular spaces are always detected in the BG or WM in elderly people, and large PVS are also prevalent in community-based population. The risk factors are different due to distribution and size, and may depend on anatomic or pathologic characteristics.
目的： 调查社区人群血管周围间隙（PVS）的影像学发现率、分布及危险因素。 方法： 自2013年6月至2016年9月纳入北京市顺义地区大孙各庄镇5个自然村年龄≥35岁，无卒中史且完成头颅MRI检查及成像清晰的受试者共1 232名。通过调查问卷、体格检查及实验室检查采集血管病相关危险因素资料；采用3.0T场强的MRI技术，以高分辨3D-T(1)WI、T(2)WI及FLAIR等序列对受试者进行检查，评估PVS人群发现率及其在基底节区、皮质下白质的分级和分布情况，使用多变量Logistic回归分析各部位PVS的危险因素。 结果： 1 232名受试者，年龄（55±10）岁，男性占37.3%（460名），所有受试者（100%）均可见基底节区和皮质下白质PVS；234例（19.0%）可观察到大的PVS（直径≥3 mm）。基底节区PVS严重程度与年龄增加（重度比轻度，每增加10岁，OR=1.81，95%CI 1.45~2.27，P<0.01）和高脂血症（OR=0.58，P=0.01）相关；皮质下白质PVS程度与年龄增加（重度比轻度，每增加9.7岁，OR=1.39，95%CI 1.13~1.71，P<0.01）相关。大的PVS危险因素为年龄增加（OR=1.03，95%CI 1.02~1.05，P<0.01）和ApoE ε4携带（OR=1.53，95%CI 1.01~2.23，P=0.04）相关。 结论： 社区人群中基底节区、皮质下白质的血管周围间隙普遍存在；不同部位、不同大小的血管周围间隙具有不同的危险因素，提示其可能存在不同的形成机制。.
Keywords: Cohort studies; Glymphatic system; Prevalence; Risk factors.