关键词: 磁共振成像,  ,  , 颈动脉超声,  ,  , 脑小血管病,  ,  , 认知障碍

Abstract:

Objective　To explore of the diagnostic efficacy of multimodal magnetic resonance imaging (MRI) indicators and carotid ultrasound indicators for patients with cerebral small vessel disease and their correlation with cognitive impairment. Methods　One hundred and ninety-five patients diagnosed with cerebral small vessel disease at Cardiovascular and Cerebrovascular Disease Hospital, Affiliated Hospital of Yan'an University from May 2020 to May 2023 were selected as the study objects. Based on the scores of the Montreal Cognitive Assessment Scale (MoCA), the patients were divided into a cognitive impairment (CL) group (106 cases) and a non-cognitive impairment (NCL) group (89 cases). If the MoCA score < 23, there is cognitive impairment. There were 56 males and 50 females in the CL group; they were (70.73±9.42) years old. There were 48 males and 41 females in the NCL group; they were (65.58±9.29) years old. The multimodal MRI parameters [white matter hyperintensities (WMH), lacunar infarcts (LI), cerebral microbleeds (CMBs), perivascular spaces (PVS), and brain atrophy] and carotid ultrasound markers (score of extracranial carotid atherosclerosis) were detected. The correlation of the multimodal MRI parameters and carotid ultrasound marker with cognitive impairment was analyzed by the Spearman correlation analysis. The diagnostic efficacy of these indicators for cerebral small vessel disease -related cognitive impairment was assessed using the receiver operating characteristic curve (ROC). t, χ², and Mann-Whitney U tests were used for the statistical analysis. Results　All the neuroimaging indicators in the NCL group were lower than those in the CL group (all P<0.05), including Fazekas score [2.00 (1.00, 2.00) vs. 3.50 (2.00, 4.00)], number of LI [1.00 (0.00, 1.00) vs. 2.00 (1.00, 3.00)], number of CMBs [1.00 (0.00, 1.00) vs. 1.00(0.00, 2.00)], CSO-PVS score [1.00 (0.00, 2.00) vs. 1.00 (1.00, 2.00)], BG-PVS score [1.00 (1.00, 2.00) vs. 1.00 (1.00, 2.00)], GCA score [1.00 (1.00, 2.00) vs. 2.00 (1.00, 2.00)], and extracranial carotid atherosclerosis score [2.00 (1.00, 3.50) vs. 4.00 (3.00, 4.00)]. The correlation analysis showed that the Fazekas score, number of LI, number of CMBs, CSO-PVS score, BG-PVS score, GCA score, and score of extracranial carotid atherosclerosis were negatively correlated with the MoCA score (r=-0.372, -0.320, -0.241, -0.163, -0.182, -0.374, and -0.191; all P<0.05). The area under the curve of the multimodal MRI parameters combined with the carotid ultrasound marker for diagnosing cognitive impairment in the patients with cerebral small vessel disease was 0.826 (95%CI 0.764-0.888), with a sensitivity of 82.1% and a specificity of 83.1%. Conclusion　There is a significant correlation of multimodal MRI and carotid ultrasound indicators with cognitive impairment in patients with cerebral small vessel disease.

Key words: Magnetic resonance imaging,  , Carotid ultrasound,  , Cerebral small vessel disease,  , Cognitive impairment