Abstract：【Objective】To investigate the correlation and clinical characteristics between imaging markers and total load of cSVD and the degree of extracranial and extracranial arteriosclerosis in patients without stroke. 【Methods】The clinical features, carotid ultrasound, magnetic resonance imaging (MRI) and computed tomography angiography (CTA) of 200 stroke-free patients were collected. The total load score of cSVD imaging markers was performed. The degree of extracranial and intracranial arteriosclerosis was evaluated according to the scores of extracranial and intracranial arteriosclerosis; The baseline data and extracranial and extracranial arteriosclerosis scores of patients with different global cSVD total load scores were compared; The correlation between various cSVD imaging marker scores, cSVD total load score and extracranial and extracranial arteriosclerosis score was analyzed. 【Results】There were significant differences in age, high homocysteine, intracranial artery stenosis, carotid plaque, intracranial arteriosclerosis score, extracranial arteriosclerosis score and total extracranial and extracranial arteriosclerosis score among patients with different total cerebral cSVD load score (P<0.01). The whole brain cSVD total load score was positively correlated with the total scores of extracranial, intracranial and extracranial arteriosclerosis (rs=0.594, 0.401 and 0.535, respectively, P<0.01); The correlation between cSVD total load score in one hemisphere and ipsilateral extracranial, intracranial and extracranial arteriosclerosis scores was significantly greater than that with contralateral extracranial, intracranial and extracranial arteriosclerosis (ipsilateral rs=0.616, 0.465 and 0.612, and contralateral rs=0.495, 0.355 and 0.478, respectively, P<0.01). Except for the PVSs score in the semioval center, the scores of other cSVD imaging markers were positively correlated with the total scores of extracranial, intracranial and extracranial arteriosclerosis.【Conclusion】The more severe the intracranial and extracranial arteriosclerosis, the heavier the ipsilateral and whole brain cSVD load; Extracranial and extracranial arteriosclerosis was positively correlated with the degree of lesions of various cSVD except PVSs in the center of semioval.
王辉, 李云霞, 刘梦, 吴婷婷, 方振平. 无卒中患者脑小血管病总负荷与颅内外动脉硬化的相关性研究[J]. 医学临床研究, 2022, 39(1): 13-17.
WANG Hui, LI Yun-xia, LIU Meng, et al. Correlation between Total Burden of Cerebrovascular Disease and Extracranial and Extracranial Arteriosclerosis in Stroke-free Patients. JOURNAL OF CLINICAL RESEARCH, 2022, 39(1): 13-17.
[1] LI Q, YANG Y, REIS C, et al. Cerebral small vessel disease[J].Cell Transplant,2018;27(12):1711-1722. [2] WARDLAW J M, SMITH E E, BIESSELS G J, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration [J].Lancet Neurol,2013,12(8): 822-838. [3] SONG T J, KIM Y D, YOO J, et al. Association between aortic atheroma and cerebral small vessel disease in patients with ischemic stroke[J].J Stroke,2016,18(3): 312-320. [4] STAALS J, MAKIN S D J, DOUBAL F N, et al. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden[J].Neurology,2014,83(14):1228-1234. [5] TOUBOUL P J, HENNERICI M G, MEAIRS S, et al. Mannheim intima-media thickness consensus [J].Cerebrovasc Dis,2004,18(4): 346-349. [6] SUTTON-TYRRELL K, ALCORN H G, WOLFSON S K, et al. Predictors of carotid stenosis in older adults with and without isolated systolic hypertension [J].Stroke,1993, 24(3): 355-361. [7] SAMUELS O B, JOSEPH G J, LYNN M J, et al. A standardized method for measuring intracranial arterial stenosis [J].AJNR Am J Neuroradiol,2000, 21(4): 643-646. [8] HUIJTS M, DUITS A, VAN OOSTENBRUGGE R J, et al.Accumulation of MRI markers of cerebral small vessel disease is associated with decreased cognitive function. A study in first-ever lacunar stroke and hypertensive patients[J].Front Aging Neurosci,2013,5:72. [9] DOUBAL F N, MACLULLICH A M J, FERGUSON K J, et al. Enlarged perivascular spaces on MRI are a feature of cerebral small vessel disease[J].Stroke,2010,41(3):450-454. [10] WAHLUND L O, BARKHOF F,FAZEKAS F, et al. A new rating scale for age-related white matter changes applicable to MRI and CT[J].Stroke,2001,32(6):1318-1322. [11] HAN F, ZHAI F F, WANG Q, et al. Prevalence and risk factors of cerebral small vessel disease in a Chinese population-based sample[J].J Stroke,2018,20(2):239-246. [12] NAM K W, KWON H M, JEONG H Y, et al. Serum homocysteine level is related to cerebral small vessel disease in a healthy population[J].Neurology,2019,92:e1-e9. [13] LI T, LIU X, DIAO S, et al. H-type hypertension is a risk factor for cerebral small-vessel disease[J].Biomed Res Int,2020,2020:6498903. [14] YOU Q, PENG Q, YU Z, et al. Plasma lipidomic analysis of sphingolipids in patients with large artery atherosclerosis cerebrovascular disease and cerebral small vessel disease[J].Biosci Rep,2020, 40(9):BSR20201519. [15] DING J, MITCHELL G F, BOTS M L, et al. Carotid arterial stiffness and risk of incident cerebral microbleeds in older people significance[J].Arterioscler Thromb Vasc Biol,2015,35(8): 1889-1895. [16] AMMIRATI E, MORONI F, MAGNONI M, et al. Relation between characteristics of carotid atherosclerotic plaques and brain white matter hyperintensities in asymptomatic patients[J].Sci Rep,2017,7(1):10559. [17] NAM K W, KWON H M, JEONG H Y, et al. Cerebral white matter hyperintensity is associated with intracranial atherosclerosis in a healthy population[J].Atherosclerosis,2017,265:179-183. [18] ZHANG K, JIANG Y, WANG Y, et al. Associations of arterial stiffness and carotid atherosclerosis with cerebral small vessel disease in a rural community-based population[J].J Atheroscler Thromb,2020,27(9): 922-933. [19] DEL BRUTTO O H, MERA R M. Enlarged perivascular spaces in the basal ganglia are independently associated with intracranial atherosclerosis in the elderly[J].Atherosclerosis,2017,267: 34-38. [20] DEL BRUTTO O H, MERA R M, DEL BRUTTO V J, et al. Cerebral small vessel disease score and atherosclerosis burden-A population study in community-dwelling older adults[J].Clin Neurol Neurosurg,2020,194:105795. [21] ZHAI F F, YANG M, WEI Y, et al. Carotid atherosclerosis, dilation, and stiffness relate to cerebral small vessel disease[J].Neurology,2020,94(17):e1811-e1819.
2022, Vol. 39 
