阻塞性睡眠呼吸暂停相关类淋巴系统功能障碍与扩大的血管周围间隙的MRI研究进展。

文献信息

中文摘要

阻塞性睡眠呼吸暂停（OSA）与脑小血管病和认知障碍风险增加密切相关。OSA不仅损害认知功能，还通过损害类淋巴系统（GS）功能促进扩大的血管周围间隙（EPVS）的发生和发展。血管周围间隙（PVS）是脑小血管病的重要影像学标志物，也是GS功能状态的形态学指标。然而，OSA相关EPVS的发病机制尚不清楚，GS功能障碍被认为是其核心。磁共振成像（MRI）是评估OSA与EPVS之间关联的关键工具，新兴的MRI技术为揭示OSA相关GS功能障碍与EPVS形成之间的潜在联系提供了影像学证据。本文综述了OSA严重程度、睡眠结构与EPVS分布之间的关系，并重点介绍了结构MRI、基于体素的形态学分析、弥散张量成像、沿血管周围间隙的弥散张量成像分析、弥散峰度成像、动态对比增强MRI、相位对比和4D flow MRI以及血氧水平依赖功能MRI在研究OSA与EPVS关系中的应用。

英文摘要

Obstructive sleep apnea (OSA) is closely associated with an increased risk of cerebral small-vessel disease and cognitive impairment. OSA not only impairs cognitive function but also promotes the occurrence and development of enlarged perivascular spaces (EPVS) by impairing glymphatic system (GS) function. Perivascular spaces (PVS) are an important imaging marker of cerebral small-vessel disease and a morphological indicator of the functional status of the GS. However, the pathogenesis of OSA-related EPVS remains unclear, with GS dysfunction considered to be at its core. Magnetic resonance imaging (MRI) is a key tool for evaluating the association between OSA and EPVS, and emerging MRI techniques have provided imaging evidence to reveal the potential link between OSA-related GS dysfunction and EPVS formation. This article reviews the relationship between OSA severity, sleep structure, and the distribution of EPVS and focuses on the application of structural MRI, voxel-based morphometry, diffusion tensor imaging, diffusion tensor imaging analysis along the perivascular spaces, diffusion kurtosis imaging, dynamic contrast-enhanced MRI, phase-contrast and 4D flow MRI, and blood oxygen level-dependent functional MRI in the study of the relationship between OSA and EPVS.