| Objective1.Using magnetic resonance imaging(MRI)to explore the distribution characteristics and correlations of total cerebral small vessel disease(CSVD)MRI burden.And exploring the correlation between the total CSVD burden and a newly proposed deep medullary vein(DMV)score.2.Based on the Mini-mental State Examination(MMSE),exploring the correlation of patients with CSVD between cognitive function on admission and the imaging markers especially total CSVD burden and DMV score.Materials and methodsBoth clinical and imaging data of 92 patients with CSVD in our hospital from September 2017 to November 2019 were retrospectively collected.Based on the MRI of patients,the patients’ CSVD imaging markers were evaluated,and the total CSVD burden scores were calculated.The distribution characteristics of the total CSVD burden were explored,and the binary logistic regression analysis was used to analyze the correlation of the various markers.DMVs of patients were evaluated on magnetic sensitivity-weighted imaging(SWI).Two neuroradiologists double-blindly evaluated the imaging data without the clinical information of patients.Kappa test was used to analyzed the consistency of the two neuroradiologists’ judgments on the DMV score and the total CSVD burden.According to the total CSVD burden,the patients were divided into three groups: the mild group(0,1 point),the moderate group(2 points),and the severe group(3,4 points).Univariate analysis and ordered logistic regression analysis were performed to explore the independent related factors of the total CSVD burden.Both clinical and imaging data of 69 patients with CSVD were retrospectivelycollected.MMSE was used to evaluate the cognitive function of patients on admission.Based on the MMSE score,patients with CSVD were divided into cognitive impairment(CI)group(MMSE score <27)and non-cognitive impairment group(MMSE score ≥27).Both univariate analysis and multi-factor binary logistic regression analysis were used to explore the independent related factors of cognitive impairment in patients with CSVD.Results1.Among the 92 CSVD patients,there were the mild group with 33(35.9%)cases,the moderate group with 21(22.8%)cases,and the severe group with 38(41.3%)cases.Agreements between neuroradiologists for the DMV score and the total CSVD burden were excellent(k=0.837、0.918).And among the patients,54(58.7%)cases had lacunae and moderate to severe perivascular space(PVS),while 36(39.1%)cases had extensive white matter hypersensitivity(WMH).Univariate analysis showed there was significant difference in the admission arterial pressure,admission venous pressure,and the DMV score among the three groups(P <0.05).After adjusting for other factors,ordered logistic regression analysis showed that only the DMV score was an independent relevant factor for the severity of the CSVD[P=0.001,OR=1.227,95%CI(1.093-1.377)].2.Among the 69 CSVD patients,there were the CI group with 17(24.6%)cases,and the non-cognitive impairment group with 52(75.4%)cases.By using univariate analysis between the groups,the age,total WMH score,PWMH score,presence of lacunes,moderate to severe PVS,total CSVD burden,and DMV score with statistical significance(P <0.05).Because of the correlations between the total CSVD burden and CSVD imaging markers,none imaging marker was included in the analysis when performing binary logistic regression analysis.The final results showed that age,total CSVD burden and DMV scores were all independently related factors of cognitive impairment[age P=0.011,OR=1.102,95%CI(1.022-1.189);total CSVD burden P=0.022,OR=2.030,95%CI(1.107-3.721);DMV score P=0.008,OR=1.339,95%CI(1.091-1.794)].Conclusion1.The patients with lacunae and moderate or severe perivascular space were the most,while the patients with extensive white matter high signal were the least.2.The newly proposed DMV score has a good consistency,and it can be further promoted in clinical efficiency and research.It is demonstrates that the DMV score is independently related to the severity of total CSVD burden,and DMVs have important observational value in patients with CSVD.In the future,DMV score can be used as an effective observation marker for the severity of CSVD and tracking the development of the disease.3.The total WMH score,PWMH score,lacunes,and moderate to severe PVS are related to cognitive impairment in patients with CSVD.Age,total CSVD burden and DMV score are independent related factors of CI in patients with CSVD.The total CSVD burden can reflect the cumulative effect of different CSVD imaging markers on cognitive function,and may have better observation value than single CVSD imaging marker.Total CSVD burden and the DMV score may provide more imaging evidence,and have important auxiliary diagnostic value for the patients with CI. |
