Wu Lingshan, Huang Hao, Yu Zhiyuan, Luo Xiang, Xu Shabei
Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
Brain Sci. 2023 Jun 30;13(7):1016. doi: 10.3390/brainsci13071016.
Cerebral small vessel disease (CSVD) commonly coexists with intracranial atherosclerotic stenosis (ICAS). Previous studies have tried to evaluate the relationship between ICAS and CSVD; however, they have yielded varied conclusions. Furthermore, the methodology of these studies is not very rigorous, as they have evaluated the association between ICAS and CSVD of bilateral hemispheres rather than the affected hemisphere. Unilateral middle cerebral artery atherosclerotic occlusion (uni-MCAO) is a favorable model to solve this problem.
Patients with uni-MCAO were retrospectively observed. Imaging characteristics, including lacunae, white matter hyperintensities (WMH), enlarged perivascular spaces (EPVS), and cerebral microbleeds (CMBs), were compared between the hemisphere ipsilateral to the MCAO and the contralateral hemisphere.
A total of 219 patients (median age 57 years; 156 males) were enrolled. Compared with the contralateral side, increased quality of lacunae (median, IQR, 0, 2 vs. 0, 1; < 0.001) and elevated CSVD score (median, IQR, 0, 1 vs. 0, 1; = 0.004) were found in the occluded hemisphere. No significant differences were shown for WMH, EPVS, and CMBs.
Uni-MCAO has a higher prevalence of lacunae in the ipsilateral hemisphere. However, no interhemispheric differences in WMH, EPVS, or CMBs were found.
脑小血管病（CSVD）常与颅内动脉粥样硬化性狭窄（ICAS）共存。既往研究试图评估ICAS与CSVD之间的关系；然而，得出的结论各不相同。此外，这些研究的方法学并不十分严谨，因为它们评估的是双侧半球而非患侧半球的ICAS与CSVD之间的关联。单侧大脑中动脉粥样硬化性闭塞（uni - MCAO）是解决这一问题的理想模型。
对uni - MCAO患者进行回顾性观察。比较MCAO同侧半球与对侧半球的影像学特征，包括腔隙、白质高信号（WMH）、血管周围间隙增宽（EPVS）和脑微出血（CMB）。
共纳入219例患者（中位年龄57岁；男性156例）。与对侧相比，闭塞半球的腔隙质量增加（中位数，四分位间距，0，2对0，1；<0.001）且CSVD评分升高（中位数，四分位间距，0，1对0，1；=0.004）。WMH、EPVS和CMB未见显著差异。
Uni - MCAO同侧半球腔隙的患病率较高。然而，未发现WMH、EPVS或CMB在半球间存在差异。
