深部髓质静脉可见性与脑小血管病影像学标志物及总负荷的关系研究

背景 深部髓质静脉(DMV)因具有便于观察和结构相对稳定的优势,已成为目前研究脑小血管病(CSVD)与静脉之间关系的切入点.目的 分析DMV可见性与CSVD影像学标志物及总负荷评分的关系.方法 选取2019年1月至2021年6月在徐州医科大学附属医院完成颅脑磁共振成像(MRI)、磁敏感加权成像(SWI)、头颈磁共振血管...

Relationship between Deep Medullary Vein Visibility and Imaging Markers and Total Burden of Cerebral Small Vessel Diseases

Background Deep medullary vein(DMV)has become the entry point to study the relationship between cerebral small vessel disease(CSVD)and vein because of its advantages of easy observation and relatively stable structure.Objective To analyze the relationship between DMV visibility and imaging markers and total load of CSVD.Methods The inpatients who completed brain magnetic resonance imaging(MRI),susceptibility-weighted imaging(SWI),head and neck magnetic resonance angiography(MRA)or CT angiography(CTA)in the Affiliated Hospital of Xuzhou Medical University from January 2019 to June 2021 were selected as the primary screening objects,and 238 patients with CSVD were finally included.They were divided into DMV low score group(DMV score<8,n=114)and DMV high score group(DMV score≥8,n=124)according to the median DMV visual score.The clinical data and imaging markers were compared between the two groups.Spearman rank correlation analysis was used to analyze the correlation between DWV visual score and total burden score of CSVD in patients with CSVD,and multivariate Logistic regression analysis was used to analyze the influencing factors of DWV visual score in patients with CSVD.Results Age in DMV high score group was older than that of DMV low score group,the proportion of patients with hypertension history,diabetes history,cerebral infarction history,taking antihypertensive drugs and homocysteine(Hcy)were higher than those in DMV low score group,total cholesterol(TC)and apolipoprotein B(ApoB)were lower than those in DMV high score group(P<0.05).In this group,there were 107 cases of angiogenic lacuna(45.1%),223 cases of white matter hyperintensity(WMH)(93.7%),190 cases of perivascular space(PVS)(79.8%),145 cases of cerebral microbleeds(CMB)(60.9%)and 57 cases of brain atrophy(23.9%).The incidence of periventricular WMH,deep WMH,lobar CMB,infratentorial/deep CMB,PVS score of basal ganglia and total load score of CSVD in DWV high score group were higher than those in DMV low group group(P<0.05).Spearman rank correlation analysis showed that DMV visual score was positively correlated with total burden score of CSVD in patients with CSVD(rs=0.717,P<0.001).Multivariate Logistic regression analysis showed that age[OR=1.045,95%CI(1.001,1.090)],periventricular WMH[OR=0.230,95%CI(0.077,0.699)],deep WMH[OR=0.323,95%CI(0.108,0.699)]and total burden score of CSVD[OR=4.222,95%CI(1.977,9.016)]were independent influencing factors of DMV visual score in CSVD patients(P<0.05).Conclusion DWV visibility was positively correlated with the total burden score of CSVD in patients with CSVD,while periventricular WMH,deep WMH and total burden of CSVD may be the factors that reduce the DMV visibility.