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目的:探讨脑小血管病患者是否存在中脑形态的改变，并分析其中脑结构特征与运动功能之间的相关性。方法:收集北京协和医院神经科2010—2018年登记的部分脑小血管病患者，所有头颅磁共振成像均使用3.0 T核磁共振成像仪采集，患者的中脑前后径及被盖前后径测量使用图像处理软件RadiAnt DICOM Viewer完成。通过问诊患者及与患者一起生活的家属，评估脑小血管病患者的运动障碍、吞咽障碍、构音障碍、排尿障碍等临床症状。采用Kinect深度摄像机结合自主开发的软件平台，对患者的运动功能进行定量评估。从所得参数中选取步速、3 m步行时间、自然起坐时间3项参数。使用SPSS 17.0软件进行统计学分析。结果:共纳入176例脑小血管病患者，年龄30~88（64.16±11.57）岁，男性占65.34%（115例）。脑小血管病患者中脑前后径、被盖前后径均与年龄呈负相关（n B=-0.032，n P<0.001；n B=-0.020，n P=0.006）。中脑前后径与运动障碍症状呈负相关（n OR=0.006，95%n CI 0~0.135，n P=0.001），调整年龄、性别后仍然相关（n OR=0.014，95%n CI 0~0.416，n P=0.013）；中脑前后径与排尿障碍症状呈负相关（n OR=0.046，95%n CI 0.002~0.936，n P=0.045），调整年龄、性别之后不再相关。被盖前后径与运动障碍症状也呈负相关（n OR=0.035，95%n CI 0.002~0.684，n P=0.027），但调整年龄、性别之后不再相关。相关分析显示步速、3 m步行时间与自然起坐时间3项运动功能评分与年龄、性别均无相关性。中脑前后径与步速呈正相关（n r=0.231，n P=0.040），与3 m步行时间呈负相关（n r=-0.304，n P=0.005），与自然起坐时间不相关，而被盖前后径与步速、3 m步行时间、自然起坐时间均无相关性。n 结论:脑小血管病患者存在中脑形态的变化，中脑结构参数与运动功能、排尿功能相关，中脑萎缩可能是脑小血管病患者出现运动障碍症状的独立相关因素。“,”Objective:To explore whether there were changes in midbrain morphology related to motor function in patients with cerebral small vessel disease (CSVD).Methods:The study was conducted on a subset of patients with CSVD registered at the Department of Neurology of Peking Union Medical College Hospital from 2010 to 2018. All magnetic resonance imaging images were taken with a 3.0 T nuclear magnetic resonance imager. The measurement of anteroposterior diameter of the mesencephalon and the tegmentum of mesencephalon was performed on a personal computer with the image processing software RadiAnt DICOM Viewer. Several clinical manifestations of dyspraxia, dysphagia, dysarthria and dysuria were evaluated by interviewing the patient and family members living with the patient. Kinect depth camera combined with self-developed software platform was used to conduct quantitative evaluation of patients′ motor function. Three parameters, namely walking speed, walking time of three meters and time of standing up and sitting down, were selected from the obtained parameters. SPSS 17.0 software was used for statistical analysis.Results:A total of 176 patients were included, aged 30-88 (64.16±11.57) years. One hundred and fifteen patients were males, accounting for 65.34%. In patients with CSVD, anteroposterior diameter of the mesencephalon and the tegmentum of mesencephalon were negatively correlated with age (n B=-0.032, n P<0.001;n B=-0.020, n P=0.006). The anteroposterior diameter of the mesencephalon was negatively correlated with symptoms of dyskinesia (n OR=0.006, 95%n CI 0-0.135, n P=0.001), even when the age and gender were adjusted (n OR=0.014,95%n CI 0-0.416,n P=0.013). The anteroposterior diameter of the mesencephalon was negatively correlated with symptoms of dysuria (n OR=0.046,95%n CI 0.002-0.936, n P=0.045), but no longer correlated when the age and gender were adjusted. The anteroposterior diameter of tegmentum of mesencephalo was also negatively correlated with symptoms of dyskinesia (n OR=0.035,95%n CI 0.002-0.684, n P=0.027), but no longer correlated after adjusting for age and gender. Video recording and evaluation of motor function were performed on 87 patients. Spearman correlation analysis showed that none of the three motor function scores was correlated with age or gender. The anteroposteric diameter of the midbrain was positively correlated with walking speed (n r=0.231n ,P=0.040) and negatively correlated with walking time of three meters (n r=-0.304,n P=0.005), but not with standing up and sitting down time, while the anteroposteric diameter of tegmentum of mesencephalo was not correlated with all of them.n Conclusion:There are changes in mesencephalon morphology in patients with CSVD, structural parameters of mesencephalon are related to motor function and urination function, and mesencephalon atrophy may be an independent related factor for symptoms of dyskinesia in patients with CSVD.