Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
Department of Vascular Ultrasonography, Xuanwu Hospital, Capital Medical University, Beijing, China; Beijing Diagnostic Center of Vascular Ultrasound, Beijing, China; Center of Vascular Ultrasonography, Beijing Institute of Brain Disorders, Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing, China.
J Clin Neurosci. 2024 Nov;129:110871. doi: 10.1016/j.jocn.2024.110871. Epub 2024 Oct 20.
Cerebral small vessel disease (CSVD) can lead to stroke and cognitive impairment. Small vessels cannot be visualized by neuroimaging directly, and CSVD can only be evaluated by cerebral parenchymal changes in MRI. Therefore, a convenient screening method for identifying high-risk and susceptible patients is needed. Recently, some studies found that CSVD was related to large atherosclerosis, and atherosclerosis was an essential pathological feature of CSVD. Therefore, we aimed to investigate the association between carotid plaque size characteristics and white matter hyperintensities (WMHs) in patients with CSVD.
We continuously enrolled patients with CSVD. Carotid plaque features were evaluated using carotid ultrasound, and WMHs were evaluated using brain magnetic resonance imaging. Plaque characteristics were compared between patients with no/mild WMHs and those with severe WMHs. Associations between the plaque characteristics and WMH severity were analyzed using logistic regression.
In total, 180 patients were recruited, of whom 92 had severe WMHs. The severe WMHs group had a higher sum of the bilateral maximum intima-media thickness (4.15 mm vs. 3.30 mm), longer maximum plaque length (17.20 mm vs. 13.90 mm), thicker plaques (2.70 mm vs. 2.30 mm), and more plaques (3 vs. 2) than the no/mild WMHs group. Adjusted logistic regression analyses revealed that maximum plaque length and thickness were associated with WMHs.
Carotid atherosclerotic plaque features, such as plaque length and thickness, were associated with the severity of WMHs, which suggested that carotid atherosclerotic plaque characteristics measured using ultrasound might be helpful indicators for identifying high-risk patients with CSVD.
脑小血管病（CSVD）可导致卒中和认知障碍。神经影像学无法直接观察到小血管，CSVD 只能通过 MRI 脑实质改变进行评估。因此，需要一种方便的筛选方法来识别高危和易感患者。最近的一些研究发现 CSVD 与大动脉粥样硬化有关，而动脉粥样硬化是 CSVD 的一个重要病理特征。因此，我们旨在探讨 CSVD 患者颈动脉斑块大小特征与脑白质高信号（WMHs）之间的关系。
我们连续招募了 CSVD 患者。使用颈动脉超声评估颈动脉斑块特征，使用脑磁共振成像评估 WMHs。比较无/轻度 WMHs 和重度 WMHs 患者的斑块特征。使用逻辑回归分析斑块特征与 WMH 严重程度之间的关系。
共纳入 180 例患者，其中 92 例有严重 WMHs。重度 WMHs 组双侧最大内膜中层厚度总和（4.15mm 比 3.30mm）、最大斑块长度（17.20mm 比 13.90mm）、斑块厚度（2.70mm 比 2.30mm）和斑块数量（3 个比 2 个）均较高。多变量逻辑回归分析显示，最大斑块长度和厚度与 WMHs 相关。
颈动脉粥样硬化斑块特征，如斑块长度和厚度，与 WMHs 严重程度相关，这提示使用超声测量颈动脉粥样硬化斑块特征可能有助于识别 CSVD 的高危患者。
