Objective To investigate the relationship between intracranial arterial dolichoectasia(IADE)and the total cerebral small vessel disease(CSVD)score in older asymptomatic patients.Methods A retrospective analysis was conducted on patients with CSVD who underwent physical examinations or consultations at the outpatient department of the Neurology Department of Beijing Hospital from January 2019 to December 2021,and who completed 3 T head magnetic resonance imaging(MRI),head magnetic resonance angiography(MRA),and head susceptibility-weighted imaging(SWI).IADE was diagnosed through imaging,and the total CSVD score was conducted.Patients were divided into IADE and non-IADE groups based on the presence or absence of IADE;they were also divided into no-mild and moderate-severe groups based on the total CSVD score.The baseline and imaging data of patients in each group were compared,and a multifactorial logistic regression analysis was used to analyze the relationship between IADE and the total CSVD score.Results A total of 230 patients with CSVD were included,with 86 cases in the IADE group and 144 cases in the non-IADE group.There were 157 cases in the no/mild CSVD total score group and 73 in the moderate/severe group.Compared with the non-IADE group,the IADE group had a higher proportion of patients with a history of cerebral infarction[16 cases(18.6％)vs.13 cases(9.0％)],those taking oral antiplatelet aggregation medication[45 cases(52.3％)vs.51(35.4％)],and patients with a moderate/severe CSVD total score[36 cases(41.9％)vs.37 cases(25.7％)].The differences were statistically significant(all P＜0.05).The proportion of patients with a moderate/severe CSVD total score in the IADE group was 41.9％(36 cases),which was significantly higher than the 25.7％(37 cases)in the non-IADE group(P＜0.05).Among the 230 patients,there were 157 in the no/mild CSVD total score group,and the proportion of IADE patients in the moderate/severe group was higher than that in the no/mild group[36 cases(49.3％)vs.50 cases(31.8％),x2=6.495,P=0.011].Multivariate logistic regression analysis showed that age[OR(95％CI)=1.777(1.124-2.808),P=0.014],history of cerebral infarction[OR(95％CI)=15.481(4.565-52.496),P＜0.001],stenosis/occlusion of intracranial and extracranial arteries[OR(95％CI)=0.961(1.003-6.804),P=0.049],and IADE[OR(95％CI)=0.037(0.879-2.563),P=0.037]were independent risk factors for moderate-severe total CSVD scores.Hemoglobin(≥135.5 g/L)[OR(95％CI)=0.283(0.114-0.701),P＜0.01]was a protective factor for moderate-severe total CSVD scores.Conclusions Patients with CSVD accompanied by IADE exhibit more pronounced whole-brain damage in neuroimaging.In addition,IADE,history of cerebral infarction,and stenosis/occlusion of intracranial arteries are independent risk factors for the severity of CSVD.
intracranial arterial dolichoectasiacerebral small vessel diseasetotal small vessel diseases corerisk factors
万方数据
维普
