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• Clinical Article •
QSM and DKI for evaluation of iron deposition and microstructural alterations in gray matter nuclei of cerebral small vessel disease with mild cognitive impairment
LI Hongjin  WANG Bo  XING Zhiyang  WANG Rongpin  ZHANG Tijiang 

Cite this article as: LI H J, WANG B, XING Z Y, et al. QSM and DKI for evaluation of iron deposition and microstructural alterations in gray matter nuclei of cerebral small vessel disease with mild cognitive impairment[J]. Chin J Magn Reson Imaging, 2025, 16(10): 28-34. DOI:10.12015/issn.1674-8034.2025.10.005.


[Abstract] Objective To investigate iron deposition and microstructural damage in gray matter nuclei of patients with cerebral small vessel disease with mild cognitive impairment (CSVD-MCI) using quantitative susceptibility mapping (QSM) and diffusional kurtosis imaging (DKI), and to explore their correlations with cognitive function.Materials and Methods The imaging and clinical data of 5 CSVD-MCI patients diagnosed in Guizhou Provincial People's Hospital from December 2022 to March 2024 were retrospectively collected. A total of 28 CSVD-MCI patients with comprehensive clinical diagnosis in Guizhou Provincial People's Hospital from March 2024 to December 2024 were prospectively enrolled. Finally, 33 CSVD-MCI patients were enrolled. Thirty-two normal controls matched for age, sex and years of education were recruited, and the Montreal Cognitive Assessment (MoCA) scores of the two groups were collected. All participants underwent 3D-T1WI, QSM and DKI sequence scanning on a GE 3.0 T superconducting MRI scanner. Using the uAI Discovery-brain platform and a brain atlas, the whole brain was segmented into 51 subregions. Bilateral gray matter nuclei, including the caudate nucleus, putamen, globus pallidus, and thalamus, were selected for analysis. Susceptibility values, kurtosis fractional anisotropy (KFA), mean kurtosis (MK), axial kurtosis (AK) and radial kurtosis (RK) were extracted for each nucleus using coarse-grained quantitative analysis based on segmentation. Between-group differences in susceptibility and DKI parameters were assessed using independent samples t-tests for normally distributed data and Mann-Whitney U tests for non-normally distributed data. Spearman correlation analysis was used to examine relationships between imaging parameters and MoCA scores. A significance threshold of P < 0.05 was applied.Results (1) No significant differences were observed between groups in age, sex, or education level (all P > 0.05), while MoCA scores differed significantly (P < 0.05). (2) Compared to HCs, the CSVD-MCI group exhibited significantly increased susceptibility in the bilateral globus pallidus (both P < 0.05). Significantly decreased KFA was observed in the bilateral caudate nucleus, putamen, and thalamus (all P < 0.05). MK showed no significant differences (P > 0.05). Significantly decreased AK was found in the bilateral caudate nucleus, right putamen, and bilateral thalamus (all P < 0.05). Significantly increased RK was observed in the bilateral putamen (both P < 0.05). (3) In the CSVD-MCI group, susceptibility in the bilateral putamen (left: r = -0.294, P = 0.017; right: r = -0.328, P = 0.008) correlated negatively with MoCA scores. KFA (r = 0.417, P = 0.016), MK (r = 0.401, P = 0.020), AK (r = 0.395, P = 0.023), and RK (r = 0.351, P = 0.045) in the left globus pallidus correlated positively with MoCA scores. Susceptibility in the bilateral putamen (left: r = -0.356, P = 0.041; right: r = -0.449, P = 0.008) correlated negatively with KFA values.Conclusions There are abnormal iron metabolism and microstructural damage in the gray matter nucleus in CSVD-MCI patients. The cognitive ability of CSVD-MCI patients is related to the iron content in bilateral putamen and the microstructural integrity of left globus pallidus. QSM and DKI provide a new perspective for early diagnosis, early intervention and personalized treatment of cerebral small vessel disease.
[Keywords] cerebral small vessel disease；cognitive impairment；magnetic resonance imaging；quantitative susceptibility mapping；diffusional kurtosis imaging

LI Hongjin1   WANG Bo2   XING Zhiyang3   WANG Rongpin1, 2*   ZHANG Tijiang1, 4*  

1 Graduate School of Zunyi Medical University, Zunyi 563000, China

2 Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, China

3 Department of Radiology, the Second Affiliated Hospital of Zunyi Medical University, Zunyi 563006, China

4 Department of Medical Technology, Bijie Medical College, Bijie 551700, China

Corresponding author: ZHANG T J, E-mail: tijzhang@163.com WANG R P, E-mail: wangrongpin@126.com

Conflicts of interest   None.

Received  2025-07-28
Accepted  2025-10-08
DOI: 10.12015/issn.1674-8034.2025.10.005
Cite this article as: LI H J, WANG B, XING Z Y, et al. QSM and DKI for evaluation of iron deposition and microstructural alterations in gray matter nuclei of cerebral small vessel disease with mild cognitive impairment[J]. Chin J Magn Reson Imaging, 2025, 16(10): 28-34. DOI:10.12015/issn.1674-8034.2025.10.005.

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