Correlation between multimodal MRI and carotid ultrasound indicators of cerebral small vessel disease and cognitive impairment

doi:10.3760/cma.j.cn441417-20240311-10018

Abstract

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

摘要：

目的　探讨多模态磁共振成像（MRI）和颈动脉超声指标在脑小血管病患者中的诊断效果及与认知障碍的相关性。方法　选取2020年5月至2023年5月延安大学附属医院心脑血管病医院收治的195例确诊为脑小血管病患者，根据蒙特利尔认知评估量表（MoCA）将患者分为认知障碍组（CL组）和非认知障碍组（NCL组），MoCA<23分为有认知障碍。CL组106例，男56例、女50例，年龄（70.73±9.42）岁；NCL组89例，男48例、女41例，年龄（65.58±9.29）岁。所有患者进行多模态MRI［脑白质高信号（WMH，采用Fazekas评分）、腔隙性脑梗死（LI）、脑微出血（CMBs）、血管周围间隙（PVS）和脑萎缩（采用GCA评分）］和颈动脉超声（颅外颈动脉硬化评分）检查。通过Spearman相关性分析多模态MRI参数和颈动脉超声指标与认知障碍之间的相关性，采用受试者操作特征曲线（ROC）评估多模态MRI和颈动脉超声指标对脑小血管病患者认知障碍的诊断效能。采用t检验、χ2检验、Mann-WhitneyU检验进行统计比较。结果　NCL组各项影像学指标均低于CL组［Fazekas评分2.00（1.00，2.00）分比3.50（2.00，4.00）分、LI个数1.00（0.00，1.00）个比2.00（1.00，3.00）个、CMBs个数1.00（0.00，1.00）个比1.00（0.00，2.00）个、半卵圆中心（CSO）-PVS评分1.00（0.00，2.00）分比1.00（1.00，2.00）分、基底神经节（BG）-PVS评分1.00（1.00，2.00）分比1.00（1.00，2.00）分、GCA评分1.00（1.00，2.00）分比2.00（1.00，2.00）分、颅外颈动脉硬化评分2.00（1.00，3.50）分比4.00（3.00，4.00）分，均P<0.05］。相关性分析显示，Fazekas评分、LI个数、CMB个数、CSO-PVS评分、BG-PVS评分、GCA评分和颅外颈动脉硬化评分与MoCA评分均呈负相关，差异均有统计学意义（r=-0.372、-0.320、-0.241、-0.163、-0.182、-0.374、-0.191，均P<0.05）。多模态MRI参数联合颈动脉超声指标诊断脑小血管病患者认知障碍的曲线下面积为0.826，95%CI为0.764～0.888，灵敏度为82.1%，特异度为83.1%。结论　多模态MRI和颈动脉超声指标与脑小血管病患者认知障碍有显著相关性。

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

Qin Jiangyan, Wang Tao, Gao Ren, Fan Zheng.

Correlation between multimodal MRI and carotid ultrasound indicators of cerebral small vessel disease and cognitive impairment [J]. International Medicine and Health Guidance News, 2025, 31(10): 1670-1675.

秦江彦王涛高任范正. 脑小血管病的多模态MRI及颈动脉超声指标与认知障碍的相关性 [J]. 国际医药卫生导报, 2025, 31(10): 1670-1675.

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