Total Deep Medullary Veins Score in Cerebral Small Vessel Disease: Association with Imaging Markers and Factors Related to Its Elevation

Abstract

Background Deep medullary veins (DMV) are small veins distributed perpendicularly to the lateral ventricles, which may have a potential role in the pathogenesis or progression of cerebral small vessel disease (CSVD) . Objective To investigate the correlation between DMVs sign and various scores of imaging markers in CSVD, and to analyze the factors related to elevated total DMVs score. Methods A retrospective design was used. Participants were 86 cases of CSVD who were selected from Neurology Department, the Second Affiliated Hospital of Zhengzhou University and Public People's Hospital of Xinzheng from January 2021 to May 2022. Their DMVs scores were assessed using a visual scoring method based on susceptibility-weighted imaging. Then the CSVD patients werer divided into mild DMVs group (n=39) and severe DMVs group (n=47) by the median total DMVs score. Imaging markers of CSVD and total CSVD burden were assessed using the common scoring method. Spearman rank correlation analysis was performed to investigate the correlation between the total score of DMVs and several imaging markers. Factors associated with elevated total score of DMVs were explored by multivariate Logistic regression analysis. Results The Spearman correlation analysis showed that total score of DMVs was positively correlated with the score of lacunes, white matter hyperintensity, deep matter hyperintensity, total white matter hyperintensity, cerebral microbleeds, enlarged perivascular spaces, or total CSVD burden (rs values were 0.386, 0.419, 0.437, 0.469, 0.562, 0.415, 0.664; P<0.05). Multivariate Logistic regression analysis showed that the history of acute cerebral stroke〔OR=5.462, 95%CI (1.387, 21.502), P=0.015〕, elevated levels of serum uric acid 〔OR=1.013, 95%CI (1.004, 1.022), P=0.005〕and hemoglobin 〔OR=1.056, 95%CI (1.006, 1.109), P=0.028〕were associated with increased total score of DMVs. Conclusion DMVs may play a rolein the development and progression of CSVD. The history of acute cerebral stroke and elevated levels of serum uric acid and hemoglobin may be related to increased total score of DMVs.

Keywords

• cerebral small vessel diseases|deep medullary veins sign|susceptibility-weighted imaging|cerebral microbleeds|root cause analysis