Carotid artery hemodynamics and geometry as predictors of cerebral small vessel disease: insights from 4D flow imaging

作者：Yurong Ma, Na Han, Juan Liang, Hui Zhang, Songhong Yue, Chuang Wu, Jintao Wang, Jing Zhang · 发表于：Neuroradiology · 年份：2025 · DOI：10.1007/s00234-025-03569-2 · 被引用次数：6 · 研究领域：Intracerebral and Subarachnoid Hemorrhage Research、Intracranial Aneurysms: Treatment and Complications、Cerebrospinal fluid and hydrocephalus

Cerebral small vessel disease (cSVD) is a common condition with complex pathophysiology, resulting in poor clinical outcomes. This study uses four-dimensional flow (4D flow) imaging to examine how carotid artery hemodynamics and geometry impact cSVD development. Combining ultrasound, 4D flow, and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA), we analyzed and measured internal carotid artery (ICA) hemodynamics and geometric parameters. Based on cranial magnetic resonance imaging (MRI) findings, the characteristics, counts, and scores of small vessel diseases were assessed. Single-factor analyses affecting cSVD were conducted, followed by multivariable logistic regression to pinpoint independent risk factors. A P -value of < 0.05 was considered statistically significant. ROC curves were used to evaluate the model’s performance and explanatory power. Multivariable analysis revealed differences in white matter hyperintensities (WMH) related to maximum pressure gradient (PG max ), with an OR Zscore of 1.602. Maximum velocity(velocity max ) negatively correlated with enlarged perivascular space (PVS) count ( P = 0.025). ICA-C5/ICA initial segment diameter ratio, velocity max , and PG max were independent risk factors for lacune (Lac) ( P < 0.01). Circumferential wall shear stress (WSS mean ) and PG max were positively correlated with cerebral microbleed (CMB) count ( P = 0.019 and P = 0.002), while the ICA-C5/ICA ratio was negatively correlated ( P = ...