Nurturing Center of Jiangsu Province for State Laboratory of AI Imaging & Interventional Radiology, Department of Radiology, Zhongda Hospital, Medical School of Southeast University, 87 Dingjiaqiao Road, Nanjing, Jiangsu 210009, China; Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, Suzhou, Jiangsu 215128, China.
Department of Radiology, The First Affiliated Hospital of Kangda College of Nanjing Medical University, Lianyungang, Jiangsu 222000, China; The First Peoples Hospital of Lianyungang, Lianyungang, Jiangsu 222000, China.
Neuroimage Clin. 2024;44:103681. doi: 10.1016/j.nicl.2024.103681. Epub 2024 Oct 2.
The spatial distribution patterns of cerebral microbleeds are associated with different types of cerebral small vessel disease (CSVD). This study aims to examine the disparities in brain imaging markers of CSVD among patients diagnosed with possible amyloid and non-amyloid small vessel disease. The head MR scans including susceptibility-weighted imaging (SWI) sequences from 351 patients at our institute were collected for analysis. CSVD imaging markers were quantified or graded across various CSVD dimensions in the patient images. Patients were categorized into the cerebral amyloid angiopathy group (CAA), hypertensive arteriopathy group (HA), or mixed small vessel disease group (Mixed), based on the spatial distribution of microbleeds. White matter lesions (WML) were segmented using an artificial neural network and assessed via a voxel-wise approach. Significant differences were observed among the three groups in several indices: microbleed count, lacune count at the centrum semiovale and basal ganglia levels, grade of enlarged perivascular space (EPVS) at the basal ganglia, and white matter lesion volume. These indices were substantially higher in the Mixed group compared to the other groups. Additionally, the incidences of cerebral hemorrhages (χ2 = 7.659, P = 0.006) and recent small subcortical infarcts (χ2 = 4.660, P = 0.031) were significantly more frequent in the HA group than in the CAA group. These results indicate that mixed spatial distribution patterns of microbleeds demonstrated the highest burden of cerebral small vessel disease. Microbleeds located in the deep brain regions were associated with a higher incidence of recent small subcortical infarcts and cerebral hemorrhages compared to those in the cortical areas.
脑微出血的空间分布模式与不同类型的脑小血管病（CSVD）有关。本研究旨在检查可能的淀粉样和非淀粉样小血管病患者的脑小血管病脑影像学标志物的差异。从我院 351 名患者的头部磁共振扫描中收集包括磁敏感加权成像（SWI）序列的图像用于分析。在患者图像中对各种 CSVD 维度的 CSVD 成像标志物进行定量或分级。根据微出血的空间分布，患者被分为脑淀粉样血管病组（CAA）、高血压性血管病组（HA）或混合小血管病组（混合组）。使用人工神经网络对白质病变（WML）进行分割，并通过体素方法进行评估。在几个指数上观察到三组之间存在显著差异：微出血计数、半卵圆中心和基底节水平的腔隙计数、基底节扩大血管周围间隙（EPVS）的分级和白质病变体积。与其他组相比，混合组的这些指数明显更高。此外，HA 组的脑出血发生率（χ2=7.659，P=0.006）和近期小皮质下梗死发生率（χ2=4.660，P=0.031）明显高于 CAA 组。这些结果表明，微出血的混合空间分布模式表现出最高的脑小血管病负担。与皮质区相比，深部脑区的微出血与近期小皮质下梗死和脑出血的发生率更高相关。
