Unveiling connections between venous disruption and cerebral small vessel disease using diffusion tensor image analysis along perivascular space (DTI-ALPS): A 7-T MRI study.

IF 6.3 2区 医学 Q1 CLINICAL NEUROLOGY
Xue Zhang, Xun Pei, Yulu Shi, Yingying Yang, Xiaoyan Bai, Tong Chen, Yuanbin Zhao, Qianqian Yang, Jinyi Ye, Xinyi Leng, Qi Yang, Ruiliang Bai, Yilong Wang, Binbin Sui
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引用次数: 0

Abstract

Background: Cerebral venous disruption is one of the characteristic findings in cerebral small vessel disease (CSVD), and its disruption may impede perivascular glymphatic drainage. And lower diffusivity along perivascular space (DTI-ALPS) index has been suggested to be with the presence and severity of CSVD. However, the relationships between venous disruption, DTI-ALPS index, and CSVD neuroimaging features remain unclear.

Aims: To investigate the association between venous integrity and perivascular diffusion activity, and explore the mediating role of DTI-ALPS index between venous disruption and CSVD imaging features.

Methods: In this cross-sectional study, 31 patients (mean age, 59.0 ± 9.9 years) were prospectively enrolled and underwent 7-T magnetic resonance (MR) imaging. DTI-ALPS index was measured to quantify the perivascular diffusivity. The visibility and continuity of deep medullary veins (DMVs) were evaluated based on a brain region-based visual score on high-resolution susceptibility-weighted imaging. White matter hyperintensity (WMH) and perivascular space (PVS) were assessed using qualitative and quantitative methods. Linear regression and mediation analysis were performed to analyze the relationships among DMV scores, DTI-ALPS index, and CSVD features.

Results: The DTI-ALPS index was significantly associated with the parietal DMV score (β = -0.573, p corrected = 0.004). Parietal DMV score was associated with WMH volume (β = 0.463, p corrected = 0.013) and PVS volume in basal ganglia (β = 0.415, p corrected = 0.028). Mediation analyses showed that DTI-ALPS index manifested a full mediating effect on the association between parietal DMV score and WMH (indirect effect = 0.115, Pm = 43.1%), as well as between parietal DMV score and PVS volume in basal ganglia (indirect effect = 0.161, Pm = 42.8%).

Conclusion: Cerebral venous disruption is associated with glymphatic activity, and with WMH and PVS volumes. Our results suggest cerebral venous integrity may play a critical role in preserving perivascular glymphatic activity; while disruption of small veins may impair the perivascular diffusivity, thereby contributing to the development of WMH and PVS enlargement.

利用沿血管周围空间的弥散张量图像分析(DTI-ALPS)揭示静脉破坏与脑小血管疾病之间的联系:7T 磁共振成像研究。
背景:脑静脉阻塞是脑小血管病(CSVD)的特征性表现之一,其阻塞可能会阻碍血管周围的甘油引流。而较低的沿血管周围间隙弥散指数(DTI-ALPS)被认为与 CSVD 的存在和严重程度有关。目的:研究静脉完整性与血管周围弥散活动之间的关系,并探讨DTI-ALPS指数在静脉破坏与CSVD影像学特征之间的中介作用:在这项横断面研究中,31 名患者(平均年龄为 59.0 ± 9.9 岁)接受了 7T 磁共振成像检查。通过测量 DTI-ALPS 指数来量化血管周围弥散度。根据基于脑区的高分辨率感性加权成像视觉评分,对髓深静脉(DMV)的可见性和连续性进行了评估。采用定性和定量方法对白质高密度(WMH)和血管周围空间(PVS)进行了评估。对DMV评分、DTI-ALPS指数和CSVD特征之间的关系进行了线性回归和中介分析:结果:DTI-ALPS指数与顶叶DMV得分显著相关[β = -0.573,p校正 = 0.004]。顶叶 DMV 评分与 WMH 体积[β = 0.463,p 校正 = 0.013]和基底节 PVS 体积(β = 0.415,p 校正 = 0.028)相关。中介分析显示,DTI-ALPS指数对顶叶DMV评分与WMH(间接效应=0.115,Pm=43.1%)以及顶叶DMV评分与基底节PVS体积(间接效应=0.161,Pm=42.8%)之间的关联具有完全中介效应:结论:脑静脉破坏与甘油活动、WMH和PVS体积有关。我们的研究结果表明,脑静脉的完整性可能在保持血管周围甘油活性方面起着关键作用;而小静脉的破坏可能会损害血管周围的弥散性,从而导致 WMH 和 PVS 扩大。
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来源期刊
International Journal of Stroke
International Journal of Stroke 医学-外周血管病
CiteScore
13.90
自引率
6.00%
发文量
132
审稿时长
6-12 weeks
期刊介绍: The International Journal of Stroke is a welcome addition to the international stroke journal landscape in that it concentrates on the clinical aspects of stroke with basic science contributions in areas of clinical interest. Reviews of current topics are broadly based to encompass not only recent advances of global interest but also those which may be more important in certain regions and the journal regularly features items of news interest from all parts of the world. To facilitate the international nature of the journal, our Associate Editors from Europe, Asia, North America and South America coordinate segments of the journal.
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