Lan Haiyuan, Lei Xinjun, Wang Chaoping, Wu Zehui, Liang Chenjing, Xu Zhihua
Department of Radiology, Lishui Hospital of Traditional Chinese Medicine Affiliated with Zhejiang Chinese Medical University, Lishui, China.
Department of Radiology, Tongde Hospital of Zhejiang Province, Hangzhou, China.
Quant Imaging Med Surg. 2024 Feb 1;14(2):1417-1428. doi: 10.21037/qims-23-426. Epub 2024 Jan 9.
Deep medullary vein (DMV) hypo-visibility is correlated with white matter hyperintensity (WMH), but the underlying causes remain unclear. This study aimed to explore the relationship between deep vein diameters and perivascular space (PVS) scores, and DMV hypo-visibility in the presence of WMH.
This cross-sectional study prospectively analyzed the clinical and imaging data of 190 cerebral small vessel disease patients with WMH and 40 healthy controls from the Lishui Hospital of Traditional Chinese Medicine affiliated with Zhejiang Chinese Medical University. PVS scores ranging from 0 to 4 were determined according to the PVS counts in the basal ganglia area on T2-weighted magnetic resonance images; high-grade PVS was defined as a PVS score >1. The diameters of the deep cerebral veins, including the bilateral septal veins (SVs), thalamostriate veins (TSVs), lateral ventricular veins (LVVs), and internal cerebral veins, were measured using susceptibility weighted imaging (SWI). Left and right DMV scores, ranging from 0 to 9, were calculated based on the visibility of the DMV on SWI in the ipsilateral frontal, parietal, and occipital lobes.
The deep cerebral vein diameters, left and right DMV scores, and high-grade PVS differed between the healthy controls and WMH patients (P<0.05). Left DMV scores were independently associated with age {β [95% confidence interval (CI)]: 0.050 (0.018, 0.082)}, high-grade PVS [β (95% CI): 0.998 (0.262, 1.737)], and the diameters of the ipsilateral SVs [β (95% CI): -1.114 (-1.754, -0.475)], SVs [β (95% CI): -0.734 (-1.191, -0.277)], and LVVs [β (95% CI): -0.921 (-1.567, -0.275)] [all false discovery rate (FDR)-corrected P<0.05]. Right DMV scores were independently associated with age [β (95% CI): 0.071 (0.037, 0.105)], high-grade PVS [β (95% CI): 0.873 (0.111, 1.635)], and the diameters of the ipsilateral SVs [β (95% CI): -0.837 (-1.386, -0.289)], TSVs [β (95% CI): -0.875 (-1.331, -0.419)], and LVVs [β (95% CI): -1.813 (-2.484, -1.142)] (all FDR-corrected P<0.05).
Decreased hypo-visibility of DMVs on SWI was associated with a higher age, the presence of high-grade PVS, and smaller diameters of the ipsilateral deep cerebral veins in individuals with WMH. Our findings provide novel insights into the probable mechanisms leading to high DMV scores.
深部髓静脉（DMV）显示不清与白质高信号（WMH）相关，但其潜在原因尚不清楚。本研究旨在探讨深部静脉直径与血管周围间隙（PVS）评分之间的关系，以及存在WMH时DMV显示不清的情况。
这项横断面研究前瞻性分析了浙江中医药大学附属丽水市中医医院190例患有WMH的脑小血管疾病患者和40名健康对照者的临床和影像数据。根据T2加权磁共振图像上基底节区的PVS计数确定PVS评分范围为0至4；高级别PVS定义为PVS评分>1。使用磁敏感加权成像（SWI）测量深部脑静脉的直径，包括双侧隔静脉（SVs）、丘脑纹状体静脉（TSVs）、侧脑室静脉（LVVs）和大脑内静脉。根据SWI上同侧额叶、顶叶和枕叶DMV的显示情况计算左右DMV评分，范围为0至9。
健康对照者和WMH患者之间深部脑静脉直径、左右DMV评分和高级别PVS存在差异（P<0.05）。左侧DMV评分与年龄{β[95%置信区间（CI）]：0.050（0.018，0.082）}、高级别PVS[β（95%CI）：0.998（0.262，1.737）]以及同侧SVs[β（95%CI）：-1.114（-1.754，-0.475）]、SVs[β（95%CI）：-0.734（-1.191，-0.277）]和LVVs[β（95%CI）：-0.921（-1.567，-0.275）]的直径独立相关[所有错误发现率（FDR）校正后P<0.05]。右侧DMV评分与年龄[β（95%CI）：0.071（0.037，0.105）]、高级别PVS[β（95%CI）：0.873（0.111，1.635）]以及同侧SVs[β（95%CI）：-0.837（-1.386，-0.289）]、TSVs[β（95%CI）：-0.875（-1.331，-0.419）]和LVVs[β（95%CI）：-1.813（-2.484，-1.142）]独立相关（所有FDR校正后P<0.05）。
SWI上DMV显示不清程度降低与年龄较大、存在高级别PVS以及WMH患者同侧深部脑静脉直径较小有关。我们的研究结果为导致高DMV评分的可能机制提供了新的见解。
