Analysis Of The Correlation Between The Imaging Characteristics Of Cerebral Microbleeds And The Imaging Markers Of Cerebral Small Vessel Disease Based On Magnetic Sensitivity Weighted Imaging

Objective This study is based on magnetic susceptibility weighted imaging(SWI)to analyze the imaging characteristics of cerebral microhaemorrhages(CMBs),including the number and location distribution,and to analyze the correlation between CMBs and the imaging markers of cerebral small vessel disease(CSVD)and the total CSVD score.The purpose of this study is to reveal the relationship between the severity and distribution of CMBs and CSVD,so as to explore the clinical application value of the imaging features of CMBs in the prevention and treatment of CSVD.Methods We selected continuousadult patients who were diagnosed as CSVD by clinical and imaging findings from January 2018 to December 2022 and were treated in the Department of Neurology of our hospital.All patients underwent head MRI scanning.Evaluating the patient’s CSVD imaging markers,including lacunar infarcts(LI),white matter hyperintensities(WMH),CMBs,perivascular spaces(PVS)and brain atrophy.The total CSVD score is used to evaluate the overall condition of CSVD.In the case of any one of LI,WMH,PVS or CMBs,the score is 1 point,and the range is 0-4.Patients were divided into two groups according to the presence of CMBs: CMBs(+)and CMBs(-).The number and location of CMBs in the CMBs(+)group were evaluated with microbleedanatomical rating scale(MARS)scale.The severity of CMBs was defined according to the number of CMBs,and divide the patients into 4groups:Level 0,0 CMBs;Level 1,1 – 4 CMBs;Level 2,5 – 9 CMBs and level 3,≥ 10 CMBs.According to the distribution of CMBs,the patients were divided into 4 groups: group A,simple lobar type;Group B,simple deep;Group C,simple infratentorial type;Group D,mixed type.Analyze the correlation between the severity and location distribution of CMBs,the total CSVD score and the imaging markers of CSVD.Results Among the 394 patients included in this study,the incidence of CMBs was52.1%,and increased with age(≤ 50 years old: 29.5%;50-60 years old:47.7%;60-70 years old: 58.5%;≥ 70 years old: 60.1%,P=0.000).There were statistical differences in the severity of CMBs in terms of age,WMH,brain atrophy and the total CSVD score(P=0.005;P < 0.001;P=0.005;P <0.001).After adjusting for age factors,the severity of CMBs was correlated withthe total CSVD score and WMH(r=0.441,P=0.000;r=0.380,P=0.000).The distribution of CMBs was as follows: simple lobar type: 21.5%,simple deep type: 14.1%,simple infratentorial type: 4.4%,mixed type: 60.0%.The location distribution of CMBs was correlated with WMH.The modified Fazekas score of mixed CMBs group was significantly higher than that of simple lobar type,simple deep type and simple subttentorial type(P=0.001;P=0.034;P=0.023).Conclusions We draw the following conclusions:(1)The incidence of CMBs is 52.1% in patients with CSVD,and the incidence of mixed type of CMBs is the highest in all types of CMBs;(2)The incidence and severity of CMBs were positively correlated with age;(3)The severity and location distribution of CMBs are related to WMH,and the severity of CMBs is related tothe total CSVD score.