Share：
Share this content in WeChat
X
[Chinese][PDF]966134
• Clinical Article •
Analysis of cerebral small vessel disease and clinical factors in young patients with symptomatic cerebral infarction
JIANG Yuhan  MIAO Yanwei  WANG Weiwei  CHE Yiwei  CHANG Peipei  SONG Qingwei  WEI Qiang  LIU Ailian 

Cite this article as: Jiang YH, Miao YW, Wang WW, et al. Analysis of cerebral small vessel disease and clinical factors in young patients with symptomatic cerebral infarction. Chin J Magn Reson Imaging, 2020, 11(2): 113-117. DOI:10.12015/issn.1674-8034.2020.02.008.


[Abstract] Objective: Cerebral small vessel disease (CSVD) is considered to be a common manifestation of senile cerebrovascular disease, and has a clear correlation with clinical symptoms and characteristics. At the present, limited studies are available for investigating the CSVD in young patients with cerebral infarction have CSVD and the impacting clinical factor, which is the aim of this explorative study.Materials and Methods: A total of 111 cases of primary acute cerebral infarction were enrolled in this study, including 54 cases of young cerebral infarction (43 men and 11 women; 39.5 yrs) with the age less than 45 years old and 57 cases of senile cerebral infarction (37 men and 20 women; 69 yrs). Ethical approval was obtained in the local institute and consent forms were obtained. Clinical data of all patients at admission were collected, including blood pressure, fasting blood glucose, total cholesterol, triglyceride, high density lipoprotein, low density lipoprotein, homocysteine, and smoking and drinking. All subjects underwent routine MR sequences (including T1WI, T2WI and T2 FLAIR) and DWI on 1.5 T MRI scanner. Two experienced radiologists evaluated the CSVD independently as the following: enlarged perivascular spaces (EPVS) were counted and scored in basal ganglia (BG) and centrum semiovale (CS); lacunar infarction (LI) were counted, white matter hyperintensity lesions (WMH) were graded and recorded. To reduce the bias in assessment of the severity of the patient's CSVD, the patient's EPVS, WMH, LI, and CMBs scores were collectively accounted to derive the total burden scores of CSVD (TBS) (0-4 scores). The Kruskal-Wallis H test were used to compare the ranked data between groups. Correlation between CSVD and clinical factors were assessed by Multivariate Logistic regression analysis.Results: Difference among the scores of the three groups was observed (P<0.01). Based on a pair-to-pair comparison, there was significant difference in TBS among the three groups (P<0.05 after adjustment). The score of the infarction group was significantly higher than that of the control group, but significantly lower than the aged group. Hypertension was observed as the influencing factor of EPVS and the influencing factors of TBS (P<0.05). Smoking was the influencing factor of CMBs (P<0.05). LI was closely related to age (P<0.05).Conclusions: Young patients with acute symptomatic cerebral infarction often combined with CSVD, and hypertension, smoking and age are the influencing factors.
[Keywords] stroke；cerebral small vessel disease；clinical factors；magnetic resonance imaging

JIANG Yuhan Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

MIAO Yanwei* Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

WANG Weiwei Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

CHE Yiwei Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

CHANG Peipei Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

SONG Qingwei Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

WEI Qiang Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

LIU Ailian Department of Radiology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, China

*Correspondence to: Miao YW, E-mail: ywmiao716@163.com

Conflicts of interest   None.

ACKNOWLEDGMENTS  This work was part of National Natural Science Foundation of China No. 81671646, 81801657
Received  2019-09-20
Accepted  2019-11-29
DOI: 10.12015/issn.1674-8034.2020.02.008
Cite this article as: Jiang YH, Miao YW, Wang WW, et al. Analysis of cerebral small vessel disease and clinical factors in young patients with symptomatic cerebral infarction. Chin J Magn Reson Imaging, 2020, 11(2): 113-117. DOI:10.12015/issn.1674-8034.2020.02.008.

[1]
Putaala J, Kurkinen M, Tarvos V, et al. Silent brain infarcts and leukoaraiosis in young adults with first-ever ischemic stroke. Neurology, 2009, 72(21): 1823-1829.
[2]
Huang Y, Yang S, Jia J. Factors related to long-term post-stroke cognitive impairment in young adult ischemic stroke. Med Sci Monit, 2015, 21: 654-660.
[3]
Pantoni L. Cerebral small vessel disease: from pathogenesis and clinical characteristics to therapeutic challenges. The Lancet Neurology, 2010, 9(7): 689-701.
[4]
Pinter D, Enzinger C, Fazekas F. Cerebral small vessel disease, cognitive reserve and cognitive dysfunction. J Neurol, 2015, 262(11): 2411-2419.
[5]
Renna R, Pilato F, Profice P, et al. Risk factor and etiology analysis of ischemic stroke in young adult patients. J Stroke Cerebrovasc Dis, 2014, 23(3): e221-e227.
[6]
Putaala J, Metso AJ, Metso TM, et al. Analysis of 1008 consecutive patients aged 15 to 49 with first-ever ischemic stroke: the Helsinki young stroke registry. Stroke, 2009, 40(4): 1195-1203.
[7]
Lutski M, Zucker I, Shohat T, et al. Characteristics and outcomes of young patients with first-ever ischemic stroke compared to older patients: the National Acute Stroke ISraeli Registry. Front Neurol, 2017, 8: 421.
[8]
中华医学会神经病学分会脑血管病学组急性缺血脑卒中诊治指南撰学组．中国急性缺血性脑卒中诊治指南2010.中华神经科杂志, 2010, 2(4): 50-59.
[9]
徐群．脑小血管病影像标志共识指南解读．神经病学与神经康复学杂志, 2016, 12(1): 17-23.
[10]
Potter GM, Chappell FM, Morris Z, et al. Cerebral perivascular spaces visible on magnetic resonance imaging: development of a qualitative rating scale and its observer reliability. Cerebrovasc Dis, 2015, 39(3-4): 224-231.
[11]
Fazekas F, Chawluk JB, Alavi A, et al. MR signal abnormalities at 1.5 T in Alzheimer's dementia and normal aging. AJR Am J Roentgenol, 1987, 149(2): 351-356.
[12]
Roob G, Lechner A, Schmidt R, et al. Frequency and location of microbleeds in patients with primary intracerebral hemorrhage. Stroke, 2000, 31(11): 2665-2669.
[13]
Roberts TPL, David M. Neuro MR: principles. J Magn Reson Imaging, 2010, 26(4): 823-837.
[14]
Reichenbach JR, Venkatesan R, Schillinger DJ, et al. Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent. Radiology, 1997, 204(1): 272-277.
[15]
Staals J, Makin SD, Doubal FN, et al. Stroke subtype, vascular risk factors, and total MRI brain small-vessel disease burden. Neurology, 2014, 83(14): 1228-1234.
[16]
Nam KW, Kwon HM, Lim JS, et al. The presence and severity of cerebral small vessel disease increases the frequency of stroke in a cohort of patients with large artery occlusive disease. PLoS one, 2017, 12(10): e0184944.
[17]
Kwon HM, Lynn MJ, Turan TN, et al. Frequency, risk factors, and outcome of coexistent small vessel disease and intracranial arterial stenosis: results from the Stenting and Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis (SAMMPRIS) trial. JAMA Neurol, 2016, 73(1): 36-42.
[18]
Wardlaw JM, Smith EE, Biessels GJ, et al. Neuroimaging standards for research into small vessel disease and its contribution to ageing and neurodegeneration. The Lancet Neurology, 2013, 12(8): 822-838.
[19]
Huijts M, Duits A, Van Oostenbrugge RJ, 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. Front Aging Neurosci, 2013, 5: 72.
[20]
Li G, Zhu C, Li J, et al. Increased level of procalcitonin is associated with total MRI burden of cerebral small vessel disease in patients with ischemic stroke. Neurosci Lett, 2018, 662: 242-246.
[21]
Klarenbeek P, van Oostenbrugge RJ, Rouhl RP, et al. Ambulatory blood pressure in patients with lacunar stroke: Association with total MRI burden of cerebral small vessel disease. Stroke, 2013, 44(11): 2995-2999.
[22]
Hurford R, Charidimou A, Fox Z, et al. MRI-visible perivascular spaces: relationship to cognition and small vessel disease MRI markers in ischaemic stroke and TIA. J Neurol Neurosurg Psychiatry, 2014, 85(5): 522-525.
[23]
Pavaine J, Young JM, Morgan BR, et al. Diffusion tensor imaging-based assessment of white matter tracts and visual-motor outcomes in very preterm neonates. Neuroradiology, 2016, 58(3): 301-310.
[24]
Gradinaru D, Borsa C, Ionescu C, et al. Oxidized LDL and NO synthesis—Biomarkers of endothelial dysfunction and ageing. Mech Ageing Dev, 2015, 151: 101-113.
[25]
Diaz KM, Veerabhadrappa P, Kashem MA, et al. Visit-to-visit and 24-h blood pressure variability: association with endothelial and smooth muscle function in African Americans. J Hum Hypertens, 2013, 27(11): 671-677.
[26]
Goldstein LB, Adams R, Becker K, et al. Primary prevention of ischemic stroke: A statement for healthcare professionals from the Stroke Council of the American Heart Association. Circulation, 2001, 103(1): 163-182.
[27]
Vermeer S. Silent brain infarcts: A systematic review. Lancet Neurol, 2007, 6(7): 611-619.

PREV Application of HR-MRI in middle cerebral atherosclerotic plaque and characteristic analysis of lenticulostriate artery
NEXT Correlation between IVIM-DWI quantitative parameter histogram and Ki-67 proliferation index of breast cancer
  


LINK


Tel & Fax: +8610-67113815    E-mail: editor@cjmri.cn