中文摘要：

目的探讨脑小血管病（cerebral small vessel disease，CSVD）患者血管周围间隙扩大（enlarged perivascular space，EPVS）及其临床意义。方法收集2011年10月至2012年2月在南京军区南京总医院住院的CSVD患者174例和非CSVD患者86例。所有患者均行头颅MRj检查（包括弥散加权成像和液体翻转衰减恢复序列），分析两组患者EPVS数量和解剖学分布，应用受试者工作特征（receiver operator characteristic，ROC）曲线探讨其解剖学分布的诊断临界值。结果多变量logistic回归分析显示，基底节区EPVs（优势比1．491，95％可信区间1．165—1．909；P=0．002）和半卵圆中心EPVS（优势比1．279，95％可信区间1．022～1．601；P=0．032）与CSVD独立相关。CSVD患者基底节区和半卵圆中心EPVS均显著多于非CSVD患者（P均=0．001），其相应的CSVD诊断临界点分别为4个和6个，ROC曲线下面积以及诊断敏感性和特异性分别是0．859、72．4％、93．0％和0．808、65．5％、95．3％。结论EPVS有助于CSVD的诊断，采用EPVS诊断CSVD时需区分解剖学部位，并确立相应的诊断临界值。

英文摘要：

Objective To investigate the enlarged perivascular space （EPVS） and its clinical sigtificance in patients with cerebral small vessel disease （CSVD）. Methods One hundred seventy-four patients with CSVD and 86 patients without CSVD admitted to Jinling Hospital, Clinical School of Nanjing University School of Medicine from October 2011 to February 2012 were recruited. All patients underwent cranial MRI examination （including diffusion-weighted imaging and fluid attenuated inversion recovery sequences）. The numbers of EPVS and anatomic distribution in all the subjects of both groups were analyzed. The receiver operator characteristic （ROC） curve was used to investigate its diagnostic critical value of anatomic distribution. Results Multivariate logistic regression analysis showed that EPVS in basal ganglia region （odds ratio [ OR] 1. 491, 95% confidence interval [ CI] 1. 165 - 1. 909; P =0. 002） and EPVS in centrum semiovale （OR 1. 279, 95% CI 1. 022 - 1. 601; P=0. 032） were independently associated with CSVD. EPVS in the basal ganglia region and the centrtun semiovale in patients with CSVD was signficantly more than that in patients with non-CSVD （all P 〈0. 001）. Its corresponding diagnosis cut-offpoints of CSVD were 4 and 6 respectively. The area under the ROC curve and the diagnostic sensitivity and specificity were 0. 859, 72. 4%, 93.0% and 0. 808, 65.5%, 95. 3%, respectively. Conclusions EPVS contributes to the diagnosis of CSVD. When using EPVS to diagnose CSVD, the anatomical sites need to be distinguished and establish appropriate diagnostic critical value.