Association of deep medullary veins with the neuroimaging burden of cerebral small vessel disease

Abstract

Background: This study aimed to explore the association between deep medullary veins (DMVs) and the neuroimaging burden of cerebral small vessel disease (CSVD). Methods:In this cross-sectional study based on a retrospective analysis, a total of 248 patients (183 males and 65 females; mean age ± standard deviation, 69.5±14.8 years) diagnosed with CSVD with complete imaging and clinical data were enrolled. Neuroimaging markers of CSVD, including white matter hyperintensities, lacunes, prominent perivascular spaces (PVSs), and cerebral microbleeds (CMBs), were identified, and the total burden of CSVD was scored. Both DMV number and DMV score were used for assessment using susceptibility-weighted imaging (SWI).Results: With the exception of perivascular spaces, more severe neuroimaging markers were observed in patients with a higher DMV score. After adjustments were made for age and body mass index (BMI), a higher DMV score (β=1.39; P<0.001) and smaller DMV number (β=-2.55; P=0.001) were associated with an increased CSVD burden. The degree of CMBs was independently correlated with both DMV score (β=1.60; P<0.001) and DMV number (β=-2.27; P=0.009). The association between lacunes and DMV score was also significant (β=0.97; P=0.026).Conclusions: Both DMV score and DMV number are potential imaging indicators of CSVD.

Imaging Interstitial Fluid With MRI: A Narrative Review on the Associations of Altered Interstitial Fluid With Vascular and Neurodegenerative Abnormalities

“…83 Furthermore, a lower deep medullar vein score was found to be associated with a lower DTI-ALPS-index. 77 This finding of 82 decreased ISF diffusivity along the venous PVS adds evidence to the theory that ISF drainage is impaired when disrupted deep medullar veins can be observed on structural susceptibility-weighted images.…”

“…Recently, venous disruption has also been proposed to be an imaging marker of cSVD. 82 Venous disruption is identified as discontinuity, inhomogeneity, and nonvisibility of deep medullar veins on susceptibility-weighted images (Fig. 7).…”

“…The visibility of disrupted deep medullar veins, or a low deep medullary vein visual score, might hint toward impaired ISF drainage through venous PVS. Reprinted with permission from Yin et al 82 …”

Energy Dynamics in Dementia & the Neurodegenerative Diseases: A New Causal Paradigm

“…WMHs are associated with decreased cerebral arterial perfusion, small lacunar infarcts and microbleeds [106][107][108][109][110][111]. MRI studies later found increased diameter of veins draining these areas suggesting increased internal pressure and venous stasis [112][113][114][115][116][117]. Pathologists also described thickening of the basement membranes of arteries and veins, both in cognitively normal elderly and people with dementia, suggesting deposition and accumulation of proteinaceous material, a small vessel pathology known as cerebral amyloid angiopathy [118][119][120][121][122][123][124][125][126].…”