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Magnetic Resonance Imaging Markers of Cerebral Small Vessel Disease in Adults with Moyamoya Disease

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Abstract

In clinical work, the magnetic resonance imaging markers of cerebral small vessel disease (CSVD) are frequently observed in moyamoya disease (MMD), but the clinical significance of these markers in MMD remains unclear. This study aimed to fill this gap and systematically investigate its clinical significance. In this retrospective cohort study, we screened all adult patients with MMD hospitalized from January 2016 to January 2020 and collected their baseline clinical and imaging information. Univariate and multivariate logistic regression analyses were then performed to determine which imaging markers were independently associated with MMD characteristics, including cerebrovascular morphology, cerebral hemodynamics, cerebrovascular events, and postoperative collateral formation (PCF). A total of 312 cerebral hemispheres images were collected from the 156 patients with MMD. Using multivariate logistic regression analysis, the following results were generated: (1) The presence of lacunes (OR, 2.094; 95% CI, 1.109–3.955; p = 0.023) and severe white matter hyperintensities (WMH) (OR, 3.204; 95% CI, 1.742–5.892; p < 0.001) were associated with a Suzuki stage ≥ IV; (2) the presence of lacunes (OR, 6.939; 95% CI, 3.384–14.230; p < 0.001), higher numbers of enlarged perivascular spaces in centrum semiovale (CSO-EPVS) (OR, 1.046; 95% CI, 1.024–1.067; p < 0.001), and severe WMH (OR, 2.764; 95% CI, 1.463–5.223; p = 0.002) were associated with the reduced regional cerebral blood flow; (3) the presence of lacunes (OR, 12.570; 95% CI, 2.893–54.624; p = 0.001), higher numbers of CSO-EPVS (OR, 1.103; 95% CI, 1.058–1.150; p < 0.001), and severe WMH (OR, 5.982; 95% CI, 1.727–20.716; p = 0.005) were associated with ischemic cerebrovascular events; (4) the higher number of CSO-EPVS (OR, 1.077; 95% CI, 1.026–1.131; p = 0.003) was associated with good PCF. The lacunes, WMH, and CSO-EPVS were independently associated with these MMD characteristics. In conclusion, this study provided a novel and potential framework for the practical assessment of MMD by magnetic resonance imaging.

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Acknowledgements

We sincerely thank Rui Guo and Zhiyuan Yu for they have provided general advice and guidance on statistical analysis.

Funding

This study was supported by funding from the National Key R&D Program of China (No. 2018YFA0108603); 1·3·5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (No. 2018HXFH007); Clinical Research Innovation Project, West China Hospital, Sichuan University (No. 2019HXCX07); 1·3·5 Project for Disciplines of Excellence⁃Clinical Research Incubation Project, West China Hospital, Sichuan University (No. 2021HXFH014); Science and Technology Department of Sichuan Province (No. 2020YFS0223); and 1·3·5 Project for Disciplines of Excellence, West China Hospital, Sichuan University (No. 2018HXFH010).

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Authors and Affiliations

  1. Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Haogeng Sun, Chao Xia, Yutao Ren, Lu Ma, Anqi Xiao, Chao You, Xiaoyu Wang, Rui Tian & Yi Liu

  2. Department of Radiology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Wanjiang Li

  3. The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2042, Australia

    Chao Xia

  4. West China Brain Research Centre, West China Hospital, Sichuan University, 37 Guoxuexiang Street, Chengdu, 610041, Sichuan, China

    Lu Ma, Anqi Xiao, Chao You, Xiaoyu Wang, Rui Tian & Yi Liu

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  1. Haogeng Sun
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Contributions

Conceptualization, H.S. and Y.L.; methodology, H.S., Y.L., and C.Y.; formal analysis and investigation, W.L., C.X., Y.R., and A.X.; writing (original draft preparation), H.S. and W.L.; writing (review and editing): L.M., R.T., Y.L., and X.W.; funding acquisition, Y.L. and C.Y.; supervision, Y.L. and C.Y..

Corresponding author

Correspondence to Yi Liu.

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Ethics Approval

The study was approved by the Institutional Review Board and Ethics Committee of West China Hospital, Sichuan University (No. 2018–219).

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Sun, H., Li, W., Xia, C. et al. Magnetic Resonance Imaging Markers of Cerebral Small Vessel Disease in Adults with Moyamoya Disease. Transl. Stroke Res. 13, 533–542 (2022). https://doi.org/10.1007/s12975-021-00973-7

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  • DOI: https://doi.org/10.1007/s12975-021-00973-7

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