Department of Radiology, 71529The Fifth People's Hospital, 71529Fudan University, Shanghai, PR China.
Department of Radiology, Tongji Hospital, 592018Tongji University, Shanghai, PR China.
Acta Radiol. 2023 Jan;64(1):295-300. doi: 10.1177/02841851211066583. Epub 2021 Dec 13.
Recent small subcortical infarcts (RSSIs) could evolve into cavitation (lacunes) or non-cavitation (white matter hyperintensities or disappearance) during the chronic period, but the factors involved remain unclear.
To explore the association between total cerebral small vessel disease (CSVD) burden and lesion cavitation.
We retrospectively selected 202 inpatients with an isolated RSSI who underwent baseline and follow-up magnetic resonance imaging (median interval = 16.6 months; interquartile range [IQR]=8.2-30.1). Inpatients were divided into cavitation and non-cavitation groups depending on whether a fluid-filled cavity formed. Data including demographic, clinical, and radiological features were collected and analyzed. To determine total CSVD burden, four imaging markers, including lacunes, microbleeds, white matter hyperintensities, and enlarged perivascular spaces, were rated and summed as a final practical score between 0 and 4.
Overall, 137 (67.8%) patients progressed to cavitation and 65 (32.2%) to non-cavitation. Binary multivariable regression analysis showed that the baseline total CSVD burden ( 0.005) and infarct diameter ( 0.002) were independent risk factors for cavitation. A severe total burden (scores of 3-4) at baseline was independently related to cavitation ( = 0.001). Moreover, the total CSVD burden score varied from 2 (IQR=1-3) at baseline to 3 (IQR=2-4) at follow-up. The extent of the increase in total burden was correlated with cavitation ( = 0.201; = 0.004).
Total CSVD burden, both the baseline value and extent of increase, was positively associated with cavitation. RSSIs with severe total CSVD burden at baseline have a greater potential to become cavitated.
最近的小皮质下梗死（RSSI）在慢性期可能发展为空洞（腔隙）或非空洞（白质高信号或消失），但涉及的因素尚不清楚。
探讨全脑小血管病（CSVD）负荷与病变空洞化的关系。
我们回顾性选择了 202 例基线和随访磁共振成像（中位数间隔=16.6 个月；四分位距[IQR]=8.2-30.1）的孤立性 RSSI 住院患者。根据是否形成充满液体的腔，将住院患者分为空洞组和非空洞组。收集并分析了包括人口统计学、临床和影像学特征在内的数据。为了确定总 CSVD 负荷，我们将 4 种影像学标志物（腔隙、微出血、白质高信号和扩大的血管周围间隙）进行评分并相加，得到 0 到 4 之间的最终实际评分。
总体而言，137 例（67.8%）患者进展为空洞，65 例（32.2%）患者进展为非空洞。二元多变量回归分析显示，基线总 CSVD 负荷（ 0.005）和梗死直径（ 0.002）是空洞的独立危险因素。基线时严重的总负荷（评分 3-4）与空洞有关（ = 0.001）。此外，总 CSVD 负荷评分从基线时的 2（IQR=1-3）变为随访时的 3（IQR=2-4）。总负荷增加的程度与空洞化相关（ = 0.201； = 0.004）。
总 CSVD 负荷，无论是基线值还是增加程度，都与空洞化呈正相关。基线时总 CSVD 负荷严重的 RSSI 更有可能发生空洞化。
