老年人群无症状脑小血管病影像学特征及其影响因素研究

目的研究老年人群无症状脑小血管病(CSVD)的发生率、影像学特征及其影响因素。方法选取2019年10月至2020年8月在我院老年医学部门诊体检、既往无神经系统疾病病史的老年人共201例, 完善头颅磁共振成像(MRI)检查。采用脑小血管病总负担评分对腔隙灶、脑白质病变、脑微出血及血管周围间隙扩大共4种CSVD影像学特征进行总体评估, 记为0～4分。分析入组人群不同影像学特征分布情况, 并将CSVD总负担评分与其临床情况进行相关性分析。结果本研究中影像学符合CSVD共133例(66.2%)。其中, 腔隙灶44例(21.9%), 中-重度脑室旁白质病变(PVWMH)88例(43.8%), 中-重度深部脑白质病变(DWMH)30例(14.9%), 基底节区血管周围间隙扩大(EPVS)61例(30.3%), 脑微出血(CMB)92例(45.8%)。CSVD总负担评分(OR=1.876, 95%CI:1.045～3.364, χ2=4.441, P=0.035)、PVWMH(OR=2.821, 95%CI:1.517～5.244, χ2=10.752, P=0.001)、DWMH(OR=2.130...

Study on imaging features of asymptomatic cerebral small vessel disease and related factors in the elderly population

Objective To investigate the incidence,neuroimaging features,and related factorsfor asymptomatic cerebral small vessel disease(CSVD)in the elderly population.Methods A total of201 elderly people with no neurological disease history who had undergone brain magnetic resonanceimaging(MRI)examination from October 2019 to August 2020 were enrolled.We calculated the totalCSVD score for each participant based on lacunar infarcts(LIs),white matter hyperintensities(WMH),enlarged perivascular spaces(EPVS),and cerebral microbleeds(CMBs)(0-4 points).CSVDneuroimaging features and the correlation between CSVD markers and clinical variables were analyzed.Results In this study,133 cases(66.2%)showed MRl features consistent with CSVD.Of whom,Lls were present in 44(21.9%),high-grade PVWMH in 88(43.8%),high-grade DWMH in 30(14.9%),basal ganglia EPVS in 61(30.3%),and CMBs in 92(45.8%).Total CSVD burden score(OR=1.876,95%CI:1.045-3.364,χ²=4.441,P=0.035),PVWMH(OR=2.821,95%CI:1.517-5.244,χ²=10.752,P=0.001),DWMH(OR=2.130,95%CI:1.108-4.092,χ²=5.145,P=0.023),and EPVS(OR=3.258,95%CI:1.675-6.334,χ²=12.129,P=0.000)were associated withhypertension.Total CSVD burden score,PVWMH,DWMH,EPVS,and CMB were correlated withincreasing age(P<0.05).LIs was positively correlated with PVWMH(b=0.231,P=0.001),DWMH(b=0.247,P=0.000)and EPVS(b=0.215,P=0.001).There was a positive relationshipbetween PVWMH and DWMH(b=0.546,P=0.000)as well as EPVS(b=0.388,P=0.000).DWMH was also positively correlated with EPVS(b=0.357,P=0.000)and CMB(b=0.177,P=0.009).Conclusions The incidence of asymptomatic CSVD is high in the elderly population.Thetotal CSVD score is a useful measure to evaluate asymptomatic cerebral small vessel disease in theelderly population.Neuroimaging features of asymptomatic CSVD are mainly correlated with age andhypertension.