Brain cerebral blood flow with MRI-visible enlarged perivascular space in adults

ObjectiveTo explore the correlation between enlarged perivascular spaces (EPVS) in the basal ganglia (BG-EPVS) and centrum semiovale (CSO-EPVS) and changes in adult brain cerebral blood flow (CBF). MethodsThis cross-sectional single-center cohort study included individuals with varying degrees of EPVS, divided into the BG and CSO based on the established rating scale. Subsequently, the arterial spin labeling (ASL) sequence and its post- processing operation were utilized to obtain CBF values for different grades of BG- EPVS and CSO-EPVS. Logistic regression was conducted to identify risk factors associated with BG-EPVS and CSO-EPVS, and correlation analysis was employed to explore the associations between different grades of BG-EPVS and CSO-EPVS with CBF of the whole brain and specific regions of interest. ResultsThe regression analysis revealed that BG-EPVS was associated with age (odds ratio [OR]: 1.10, 95% confidence interval [CI]: 1.04-1.15), hypertension (4.91,1.55-15.6), and periventricular white matter hyperintensities (PVWMH) (4.34,1.46-12.95). Conversely, CSO-EPVS was linked to hypertension (4.40,1.43- 13.57), drinking history (2.84,1.08-7.45), sleep duration (2.01,1.19-3.40), and PVWMH (12.20,3.83-38.85). Correlation analysis revealed a negative correlation between BG-EPVS and the CBF of the whole brain (r=-0.28, p=0.00) and most brain regions, except for the brain stem (r=-0.19, p=0.05). Conversely, CSO-EPVS was negatively correlated with CBF of temporal lobe white matter (r=-0.25, p=0.01); however, the significance was lost after FDR correction. CSO-EPVS was not correlated with CBF across various brain regions. ConclusionBrain CBF decreased with the increasing severity of BG-EPVS, suggesting that BG-EPVS could serve as an imaging marker for reflecting the changes in brain CBF and an effective indicator for early ischemic stroke.