Dentate nucleus dilated perivascular spaces on magnetic resonance imaging in hypertensive arteriopathy

BACKGROUND: Small vessel disease (SVD)-related MRI abnormalities include cerebral microbleeds (CMB), intracerebral hemorrhage (ICH) and supratentorial dilated perivascular spaces (DPVS). In the cerebellum, deep CMB/ICH involving dentate nucleus (DN) is associated with hypertensive arteriopathy (HA), whereas superficial cerebellar CMB/ICH is associated with cerebral amyloid angiopathy (CAA). We studied DPVS inside DN (DN-DPVS) in patients with HA or CAA. METHODS: We retrospectively analyzed DN-DPVS presence and number on T2-weighted 3T MRI (performed on follow-up in the vast majority of cases) from 29 HA and 43 CAA patients with hemorrhage-related symptoms, consecutively recruited. Assessed characteristics were sex, age, cardiovascular risk factors, time between initial CAA/HA diagnosis and MRI, magnet, axial/coronal imaging, hemorrhagic lesions on T2*-weighted imaging, semi-quantitative supratentorial DPVS rating score for centrum semiovale and basal ganglia DPVS, and DN-DPVS presence and number. RESULTS: On univariate analysis, compared with CAA, HA patients were younger (median age 73 vs. 76, p=0.015), more frequently had diabetes (24% vs. 5%, p=0.014), showed fewer CMB (median 1 vs. 3, p=0.013), higher basal ganglia DPVS scores (p