Intracranial vessel wall lesions on 7T MRI and MRI features of cerebral small vessel disease-The SMART-MR study
Zwartbol, Maarten Ht; van der Kolk, Anja G; Kuijf, Hugo J; Witkamp, Theo D; Ghaznawi, Rashid; Hendrikse, Jeroen; Geerlings, Mirjam I; UCC-SMART Study Group*
(2021) Journal of Cerebral Blood Flow and Metabolism, volume 41, issue 6, pp. 1219 - 1228
(Article)
Abstract
The etiology of cerebral small vessel disease (CSVD) is the subject of ongoing research. Although intracranial atherosclerosis (ICAS) has been proposed as a possible cause, studies on their relationship remain sparse. We used 7 T vessel wall magnetic resonance imaging (MRI) to study the association between intracranial vessel wall lesions-a neuroimaging
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marker of ICAS-and MRI features of CSVD. Within the SMART-MR study, cross-sectional analyses were performed in 130 patients (68 ± 9 years; 88% male). ICAS burden-defined as the number of vessel wall lesions-was determined on 7 T vessel wall MRI. CSVD features were determined on 1.5 T and 7 T MRI. Associations between ICAS burden and CSVD features were estimated with linear or modified Poisson regression, adjusted for age, sex, vascular risk factors, and medication use. In 125 patients, ≥1 vessel wall lesions were found (mean 8.5 ± 5.7 lesions). ICAS burden (per + 1 SD) was associated with presence of large subcortical and/or cortical infarcts (RR = 1.65; 95%CI: 1.12-2.43), lacunes (RR = 1.45; 95% CI: 1.14-1.86), cortical microinfarcts (RR = 1.48; 95%CI: 1.13-1.94), and total white matter hyperintensity volume (b = 0.24; 95%CI: 0.02-0.46). Concluding, patients with a higher ICAS burden had more CSVD features, although no evidence of co-location was observed. Further longitudinal studies are required to determine if ICAS precedes development of CSVD.
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Keywords: cerebral small vessel disease, Intracranial atherosclerosis, lacunes of presumed vascular origin, vessel wall imaging, white matter hyperintensities, Clinical Neurology, Neurology, Cardiology and Cardiovascular Medicine, Journal Article
ISSN: 0271-678X
Publisher: Nature Publishing Group
Note: Funding Information: We gratefully acknowledge the contribution of the SMART research nurses; R van Petersen (data-manager); BGF Dinther (vascular manager), and the members of the Utrecht Cardiovascular Cohort-Second Manifestations of ARTerial disease-Studygroup (UCC-SMART-Studygroup): FW Asselbergs and HM Nathoe, Department of Cardiology; GJ de Borst, Department of Vascular Surgery; ML Bots and MI Geerlings, Julius Center for Health Sciences and Primary Care; MH Emmelot, Department of Geriatrics; PA de Jong and T Leiner, Department of Radiology; AT Lely, Department of Obstetrics & Gynecology; NP van der Kaaij, Department of Cardiothoracic Surgery; LJ Kappelle and YM Ruigrok, Department of Neurology; MC Verhaar, Department of Nephrology; and FLJ Visseren (chair) and J Westerink, Department of Vascular Medicine, University Medical Center Utrecht and Utrecht University. The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research of Jeroen Hendrikse has received funding from the European Research Council under the European Union?s Horizon 2020 Programme (H2020)/ERC grant agreement no. 637024 (HEARTOFSTROKE) and H2020 grant agreement no. 666881, SVDs@target. Jeroen Hendrikse is supported by the Netherlands Organization for Scientific Research (NWO) under grant no. 91712322. Publisher Copyright: © The Author(s) 2020.
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