Deep medullary vein damage correlates with small vessel disease in small vessel occlusion acute ischemic stroke

作者：Xueyang Wang, Jinhao Lyu, Qi Duan, Chenxi Li, Jiayu Huang, Zhihua Meng, Xiaoyan Wu, Wen Chen, Guohua Wang, Qingliang Niu, Xin Li, Yitong Bian, Dan Han, Weiting Guo, Shuai Yang, Xiangbing Bian, Yina Lan, Liuxian Wang, Tingyang Zhang, Caohui Duan, Xin Lou, on behalf of the MR-STARS Investigators · 发表于：European Radiology · 年份：2024 · DOI：10.1007/s00330-024-10628-4 · 被引用次数：10 · 研究领域：Cerebral Venous Sinus Thrombosis、Intracerebral and Subarachnoid Hemorrhage Research、Acute Ischemic Stroke Management

OBJECTIVES: We aim to investigate whether cerebral small vessel disease (cSVD) imaging markers correlate with deep medullary vein (DMV) damage in small vessel occlusion acute ischemic stroke (SVO-AIS) patients. METHODS: The DMV was divided into six segments according to the regional anatomy. The total DMV score (0-18) was calculated based on segmental continuity and visibility. The damage of DMV was grouped according to the quartiles of the total DMV score. Neuroimaging biomarkers of cSVD including white matter hyperintensity (WMH), cerebral microbleed (CMB), perivascular space (PVS), and lacune were identified. The cSVD score were further analyzed. RESULTS: We included 229 SVO-AIS patients, the mean age was 63.7 ± 23.1 years, the median NIHSS score was 3 (IQR, 2-6). In the severe DMV burden group (the 4th quartile), the NIHSS score grade (6 (3-9)) was significantly higher than other groups (p < 0.01). The grade scores for basal ganglia PVS (BG-PVS) were positively correlated with the degree of DMV (R = 0.67, p < 0.01), rather than centrum semivole PVS (CS-PVS) (R = 0.17, p = 0.1). In multivariate analysis, high CMB burden (adjusted odds ratio [aOR], 25.38; 95% confidence interval [CI], 1.87-345.23) was associated with severe DMV scores. In addition, BG-PVS was related to severe DMV burden in a dose-dependent manner: when BG-PVS score was 3 and 4, the aORs of severe DMV burden were 18.5 and 12.19, respectively. CONCLUSION: The DMV impairment was associated with the severity o...