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Deep white matter hyperintensity is spatially correlated to MRI-visible perivascular spaces in cerebral small vessel disease on 7 Tesla MRI

Yajing Huo, Yilin Wang, Cen Guo, Qianyun Liu, Lili Shan, Mingyuan Liu, Haibo Wu, Guanwu Li, Huihui Lv, Lingdan Lu, Yintin Zhou, Jianfeng Feng, Yan Han
DOI: 10.1136/svn-2022-001611 Published 25 April 2023
Yajing Huo
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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  • ORCID record for Yajing Huo
Yilin Wang
2 Georgetown Preparatory School, North Bethesda, Maryland, USA
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Cen Guo
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Qianyun Liu
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Lili Shan
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Mingyuan Liu
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Haibo Wu
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Guanwu Li
3 Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Huihui Lv
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Lingdan Lu
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Yintin Zhou
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Jianfeng Feng
4 Institute of Science and Technology for Brain-inspired Intelligence, Fudan University, Shanghai, China
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Yan Han
1 Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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  • Figure 1
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    Figure 1

    Flow chart of enrollment in this study. WMH, white matter hyperintensity.

  • Figure 2
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    Figure 2

    Illustration of reference sites of dWMH. The degrees of the dilatation and number of PVS within a spherical area with a radius of 1 cm around dWMH and the anatomically corresponding reference area in the contralateral hemisphere were evaluated in axil plane (A), coronal plane (B) and sagittal plane (C and D). dWMH, deep white matter hyperintensity; PVS, perivascular space.

  • Figure 3
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    Figure 3

    The reference template used for the grading of PVS. From above to below, each template illustrates different extents of the dilatation of PVS. A single location was revealed in three directions (from left to right: axial, coronal, sagittal) in each row. PVS, perivascular space.

  • Figure 4
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    Figure 4

    Illustration of spatial connections between WMH and PVS. (A) Type 1, small punctate WMH (yellow arrow) was spatially connected with one PVS tube. (B) Type 2, flake-like WMH (yellow arrow) was connected with multiple tubes. (C) Type 3, insular WMH (yellow arrow) without PVS connection. PVS, perivascular space; WMH, white matter hyperintensity.

  • Figure 5
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    Figure 5

    Comparison of CSO-PVS scores among subjects without, with ≤5 and with >5 WMLs. *indicates p<0.05. The results are showed as means±SEM. CSO-PVS, centrum semiovale-perivascular space; WMLs, white matter lesions.

Tables

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  • Table 1

    Baseline characteristics of patients with WMHs and controls without WMHs

    CategoryPatients with WMHsControls (n=16)
    P value
    ≤5 WMLs (n=16)>5 WMLs (n=16)
    Age (mean±SD, year)44.06±6.1344.00±6.8942.75±6.260.81
    Female, n (%)7 (43.8)6 (37.5)6 (37.5)0.917
    Current smoker, n (%)3 (18.8)3 (18.8)2 (12.5)1
    Alcohol user, n (%)0 (0.0)1 (6.3)3 (18.8)0.304
    Hypertension, n (%)1 (6.3)3 (18.8)2 (12.5)0.859
    Diabetes mellitus, n (%)0 (0.0)0 (0.0)1 (6.3)1
    Hyperlipidaemia, n (%)2 (12.5)5 (31.3)3 (18.8)0.556
    Lacunes, n(%)0 (0.0)3 (18.6)0 (0.0)0.097
    CMBs, n(%)1 (6.3)1 (6.3)0 (0.0)1
    • CMBs, cerebral microbleeds; WMH, white matter hyperintensity; WML, white matter lesion.

  • Table 2

    The degree of PVS dilatation in NAWM surrounding dWMH and reference site


    N(%)
    Reference site
    Total
    012
    dWMH
     00 (0.0%)2 (100%)0 (0.0%)2
     13 (3.2%)85 (91.4%)5 (5.4%)93
     23 (4.5%)39 (59.1%)24 (36.4%)66
     30 (0.0%)1 (33.3%)2 (66.7%)3
    total612731164
    • dWMH, deep white matter hyperintensity; NAWM, normal-appearing white matter; PVS, perivascular space.

  • Table 3

    The degree of PVS number in NAWM surrounding dWMH and reference site


    N (%)
    Reference site
    Total
    012345
    dWMH
     00 (0.0%)2 (100%)0 (0.0%)0 (0.0%)0 (0.0%)0 (0.0%)2
     15 (8.9%)48 (85.7%)3 (5.4%)0 (0.0%)0 (0.0%)0 (0.0%)56
     21 (1.4%)40 (55.6%)27 (37.5%)4 (5.6%)0 (0.0%)0 (0.0%)72
     30 (0.0%)7 (30.4%)14 (60.9%)2 (8.7%)0 (0.0%)0 (0.0%)23
     40 (0.0%)2 (25.0%)2 (25.0%)4 (50.0%)0 (0.0%)0 (0.0%)8
     50 (0.0%)0 (0.0%)1 (33.3%)0 (0.0%)1 (33.3%)1 (33.3%)3
    Total699471011164
    • dWMH, deep white matter hyperintensity; NAWM, normal-appearing white matter; PVS, perivascular space.

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Stroke and Vascular Neurology: 8 (2)
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Deep white matter hyperintensity is spatially correlated to MRI-visible perivascular spaces in cerebral small vessel disease on 7 Tesla MRI
Yajing Huo, Yilin Wang, Cen Guo, Qianyun Liu, Lili Shan, Mingyuan Liu, Haibo Wu, Guanwu Li, Huihui Lv, Lingdan Lu, Yintin Zhou, Jianfeng Feng, Yan Han
Stroke and Vascular Neurology Apr 2023, 8 (2) 144-150; DOI: 10.1136/svn-2022-001611

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Deep white matter hyperintensity is spatially correlated to MRI-visible perivascular spaces in cerebral small vessel disease on 7 Tesla MRI
Yajing Huo, Yilin Wang, Cen Guo, Qianyun Liu, Lili Shan, Mingyuan Liu, Haibo Wu, Guanwu Li, Huihui Lv, Lingdan Lu, Yintin Zhou, Jianfeng Feng, Yan Han
Stroke and Vascular Neurology Apr 2023, 8 (2) 144-150; DOI: 10.1136/svn-2022-001611
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Deep white matter hyperintensity is spatially correlated to MRI-visible perivascular spaces in cerebral small vessel disease on 7 Tesla MRI
Yajing Huo, Yilin Wang, Cen Guo, Qianyun Liu, Lili Shan, Mingyuan Liu, Haibo Wu, Guanwu Li, Huihui Lv, Lingdan Lu, Yintin Zhou, Jianfeng Feng, Yan Han
Stroke and Vascular Neurology Apr 2023, 8 (2) 144-150; DOI: 10.1136/svn-2022-001611
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