Tracking the changes in longitudinal MRI-detected perivascular spaces following ischaemic stroke.

IF 5.2 3区医学 Q1 CLINICAL NEUROLOGY

European Stroke Journal Pub Date : 2026-09-05 DOI:10.1093/esj/aakag108

William Pham, Mohamed S Khlif, Zhibin Chen, Alexander Jarema, Luke A Henderson, Vaughan G Macefield, Amy Brodtmann

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引用次数: 0

Abstract

Introduction: Stroke is a leading cause of mortality and morbidity worldwide. Magnetic resonance imaging-visible perivascular spaces (PVS) are an emerging marker of cerebral small vessel disease and may have prognostic value in stroke. We aimed to characterise longitudinal changes in PVS volume and cluster count following ischaemic stroke.

Patients and methods: Perivascular space volumes and cluster counts were compared between stroke survivors (n = 124; 39 women; median [Q1, Q3] age = 70 [62, 76] years) and healthy controls (n = 39; 15 women; median age = 69 [66, 72.5] years). Magnetic resonance imaging scans were acquired at 3 months, 12 months and 36 months post-stroke. Perivascular spaces were automatically segmented from T1-weighted MRI using a validated deep learning algorithm (nnU-Net). Generalised linear mixed-effects models were used to assess group differences and longitudinal changes in PVS, adjusting for baseline age, sex, total intracranial volume and body mass index.

Results: At the 3-month timepoint, whole-brain PVS metrics were significantly greater in the stroke group than in controls. By 36 months, stroke patients demonstrated significant PVS reductions relative to controls in the frontal lobe (PVS volume: exp(β) = 0.93; 95% CI, 0.82, 0.99, P = .032; PVS cluster count: exp(β) = 0.91; 95% CI, 0.83, 1; P = .037).

Discussion: Contrary to age-related PVS enlargement observed in controls, stroke survivors showed significant longitudinal reductions in PVS volume and cluster counts over 36 months. These findings suggest that MRI-visible PVS trajectories after stroke are dynamic and region-specific, challenging the interpretation of PVS enlargement as a simple marker of cerebrovascular disease burden.

Conclusion: Ischaemic stroke is associated with dynamic and regional changes in PVS volume and count.

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追踪缺血性脑卒中后纵向mri检测血管周围空间的变化。

脑卒中是世界范围内死亡和发病的主要原因。磁共振成像-可见血管周围间隙（PVS）是一种新兴的脑血管疾病标志物，可能对中风有预后价值。我们的目的是描述缺血性脑卒中后PVS体积和簇数的纵向变化。患者和方法：比较脑卒中幸存者（n = 124； 39名女性；中位年龄[Q1， Q3] = 70[62,76]岁）和健康对照组（n = 39； 15名女性；中位年龄= 69[66,72.5]岁）的血管周围空间体积和簇数。脑卒中后3个月、12个月和36个月分别进行磁共振成像扫描。使用经过验证的深度学习算法（nnU-Net）从t1加权MRI中自动分割血管周围空间。采用广义线性混合效应模型评估各组差异和PVS的纵向变化，调整基线年龄、性别、颅内总容积和体重指数。结果：在3个月的时间点，卒中组的全脑PVS指标明显高于对照组。到36个月时，卒中患者表现出相对于对照组的额叶PVS显著减少(PVS体积：exp(β) = 0.93；95% ci, 0.82, 0.99, p = 0.032；PVS簇数：exp(β) = 0.91；95% ci, 0.83, 1；p = .037)。讨论：与对照组中观察到的与年龄相关的PVS扩大相反，中风幸存者在36个月内显示出PVS体积和簇数的显著纵向减少。这些发现表明，脑卒中后mri可见的PVS轨迹是动态的和区域特异性的，挑战了PVS扩大作为脑血管疾病负担的简单标志的解释。结论：缺血性脑卒中与PVS体积和计数的动态和局部变化有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

European Stroke Journal Multiple-

CiteScore

7.50

自引率

6.60%

发文量

102

期刊介绍： Launched in 2016 the European Stroke Journal (ESJ) is the official journal of the European Stroke Organisation (ESO), a professional non-profit organization with over 1,400 individual members, and affiliations to numerous related national and international societies. ESJ covers clinical stroke research from all fields, including clinical trials, epidemiology, primary and secondary prevention, diagnosis, acute and post-acute management, guidelines, translation of experimental findings into clinical practice, rehabilitation, organisation of stroke care, and societal impact. It is open to authors from all relevant medical and health professions. Article types include review articles, original research, protocols, guidelines, editorials and letters to the Editor. Through ESJ, authors and researchers have gained a new platform for the rapid and professional publication of peer reviewed scientific material of the highest standards; publication in ESJ is highly competitive. The journal and its editorial team has developed excellent cooperation with sister organisations such as the World Stroke Organisation and the International Journal of Stroke, and the American Heart Organization/American Stroke Association and the journal Stroke. ESJ is fully peer-reviewed and is a member of the Committee on Publication Ethics (COPE). Issues are published 4 times a year (March, June, September and December) and articles are published OnlineFirst prior to issue publication.