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<p>This study aimed to investigate perivascular spaces (PVS), Diffusion tensor imaging (DTI)-derived indices, and choroid plexus in patients with iNPH and to assess potential associations between these MRI indices and ventriculomegaly and WMH.</p><p>This single-center, cross-sectional retrospective study included healthy controls (HCs) and patients with iNPH who underwent 3.0T MRI measurements including MRI-visible PVS volume fraction (PVSVF), fractional volume of free water in white matter (FW-WM), the diffusion tensor image analysis along the perivascular space (DTI-ALPS), and choroid plexus volume fraction (CPVF). Among them, FW-WM and DTI-ALPS are DTI-derived indices. MRI measurements were compared and correlated with ventricular parameters and WMH in both groups using general linear univariate model and partial Spearman rank correlation tests.</p><p>Fifty-six patients with iNPH (71.5 ± 7.7 years; 34 males) and 47 HCs (69.1 ± 6.3 years; 26 males) were analyzed. Patients with iNPH had significantly higher PVSVF, FW-WM, and CPVF, and a lower DTI-ALPS index than HCs (all <i>p</i> &lt; 0.001). Lower DTI-ALPS (iNPH group: <i>r</i> = -0.625; HCs group <i>r</i> = -0.629; all p corrected for false discovery rate (FDR) &lt; 0.001) and higher CPVF (iNPH group: <i>r</i> = 0.462, p<sub>FDR</sub> &lt; 0.001; HCs group <i>r</i> = 0.444, p<sub>FDR</sub> = 0.027) were correlated with a larger relative ventricular volume. Lower DTI-ALPS (<i>r</i> = 0.390, p<sub>FDR</sub> = 0.030) and higher CPVF (<i>r</i> = -0.385, p<sub>FDR</sub> = 0.023) correlated with lower relative extra-ventricular CSF volume only in the iNPH group.</p><p>iNPH exhibited higher PVS, FW-WM, and CPVS and lower DTI-ALPS. Lower DTI-ALPS and higher CPVS may play important roles in ventriculomegaly and alterations in CSF distribution in iNPH.</p>

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Association between perivascular spaces, DTI-derived Indices, and choroid plexus with ventriculomegaly and white matter hyperintensity in idiopathic normal pressure hydrocephalus

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年10月13日

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  • Wenjie He,
  • Xi Zhou,
  • Zekai Chen,
  • Jialing Lv,
  • Qizhong Xu,
  • Jun Xia,
  • Guihua Jiang

摘要

This study aimed to investigate perivascular spaces (PVS), Diffusion tensor imaging (DTI)-derived indices, and choroid plexus in patients with iNPH and to assess potential associations between these MRI indices and ventriculomegaly and WMH.

This single-center, cross-sectional retrospective study included healthy controls (HCs) and patients with iNPH who underwent 3.0T MRI measurements including MRI-visible PVS volume fraction (PVSVF), fractional volume of free water in white matter (FW-WM), the diffusion tensor image analysis along the perivascular space (DTI-ALPS), and choroid plexus volume fraction (CPVF). Among them, FW-WM and DTI-ALPS are DTI-derived indices. MRI measurements were compared and correlated with ventricular parameters and WMH in both groups using general linear univariate model and partial Spearman rank correlation tests.

Fifty-six patients with iNPH (71.5 ± 7.7 years; 34 males) and 47 HCs (69.1 ± 6.3 years; 26 males) were analyzed. Patients with iNPH had significantly higher PVSVF, FW-WM, and CPVF, and a lower DTI-ALPS index than HCs (all p < 0.001). Lower DTI-ALPS (iNPH group: r = -0.625; HCs group r = -0.629; all p corrected for false discovery rate (FDR) < 0.001) and higher CPVF (iNPH group: r = 0.462, pFDR < 0.001; HCs group r = 0.444, pFDR = 0.027) were correlated with a larger relative ventricular volume. Lower DTI-ALPS (r = 0.390, pFDR = 0.030) and higher CPVF (r = -0.385, pFDR = 0.023) correlated with lower relative extra-ventricular CSF volume only in the iNPH group.

iNPH exhibited higher PVS, FW-WM, and CPVS and lower DTI-ALPS. Lower DTI-ALPS and higher CPVS may play important roles in ventriculomegaly and alterations in CSF distribution in iNPH.