Yurong Ma, Na Han, Juan Liang, Hui Zhang, Songhong Yue, Chuang Wu, Jintao Wang, Jing Zhang
{"title":"颈动脉血流动力学和几何作为脑血管疾病的预测指标：来自4D血流成像的见解。","authors":"Yurong Ma, Na Han, Juan Liang, Hui Zhang, Songhong Yue, Chuang Wu, Jintao Wang, Jing Zhang","doi":"10.1007/s00234-025-03569-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong>Cerebral small vessel disease (cSVD) is a common condition with complex pathophysiology, resulting in poor clinical outcomes. This study uses four-dimensional flow (4D flow) imaging to examine how carotid artery hemodynamics and geometry impact cSVD development.</p><p><strong>Methods: </strong>Combining ultrasound, 4D flow, and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA), we analyzed and measured internal carotid artery (ICA) hemodynamics and geometric parameters. Based on cranial magnetic resonance imaging (MRI) findings, the characteristics, counts, and scores of small vessel diseases were assessed. Single-factor analyses affecting cSVD were conducted, followed by multivariable logistic regression to pinpoint independent risk factors. A P-value of < 0.05 was considered statistically significant. ROC curves were used to evaluate the model's performance and explanatory power.</p><p><strong>Results: </strong>Multivariable analysis revealed differences in white matter hyperintensities (WMH) related to maximum pressure gradient (PG<sub>max</sub>), with an OR<sub>Zscore</sub> of 1.602. Maximum velocity(velocity<sub>max</sub>) negatively correlated with enlarged perivascular space (PVS) count (P = 0.025). ICA-C5/ICA initial segment diameter ratio, velocity<sub>max</sub>, and PG<sub>max</sub> were independent risk factors for lacune (Lac) (P < 0.01). Circumferential wall shear stress (WSS<sub>mean</sub>) and PG<sub>max</sub> were positively correlated with cerebral microbleed (CMB) count (P = 0.019 and P = 0.002), while the ICA-C5/ICA ratio was negatively correlated (P = 0.003). The MCA/ICA-C5 diameter ratio was positively associated with SVD score (P = 0.021). ROC curves demonstrated strong model performance for WMH and Lac.</p><p><strong>Conclusion: </strong>Diameter variations in the ICA and MCA may indicate changes in vascular compliance and potential remodeling abnormalities. Hemodynamic anomalies in the ICA's initial segment could suggest distal vascular disease, offering new insights into cSVD pathogenesis.</p>","PeriodicalId":19422,"journal":{"name":"Neuroradiology","volume":" ","pages":"961-975"},"PeriodicalIF":2.8000,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Carotid artery hemodynamics and geometry as predictors of cerebral small vessel disease: insights from 4D flow imaging.\",\"authors\":\"Yurong Ma, Na Han, Juan Liang, Hui Zhang, Songhong Yue, Chuang Wu, Jintao Wang, Jing Zhang\",\"doi\":\"10.1007/s00234-025-03569-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong>Cerebral small vessel disease (cSVD) is a common condition with complex pathophysiology, resulting in poor clinical outcomes. This study uses four-dimensional flow (4D flow) imaging to examine how carotid artery hemodynamics and geometry impact cSVD development.</p><p><strong>Methods: </strong>Combining ultrasound, 4D flow, and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA), we analyzed and measured internal carotid artery (ICA) hemodynamics and geometric parameters. Based on cranial magnetic resonance imaging (MRI) findings, the characteristics, counts, and scores of small vessel diseases were assessed. Single-factor analyses affecting cSVD were conducted, followed by multivariable logistic regression to pinpoint independent risk factors. A P-value of < 0.05 was considered statistically significant. ROC curves were used to evaluate the model's performance and explanatory power.</p><p><strong>Results: </strong>Multivariable analysis revealed differences in white matter hyperintensities (WMH) related to maximum pressure gradient (PG<sub>max</sub>), with an OR<sub>Zscore</sub> of 1.602. Maximum velocity(velocity<sub>max</sub>) negatively correlated with enlarged perivascular space (PVS) count (P = 0.025). ICA-C5/ICA initial segment diameter ratio, velocity<sub>max</sub>, and PG<sub>max</sub> were independent risk factors for lacune (Lac) (P < 0.01). Circumferential wall shear stress (WSS<sub>mean</sub>) and PG<sub>max</sub> were positively correlated with cerebral microbleed (CMB) count (P = 0.019 and P = 0.002), while the ICA-C5/ICA ratio was negatively correlated (P = 0.003). The MCA/ICA-C5 diameter ratio was positively associated with SVD score (P = 0.021). ROC curves demonstrated strong model performance for WMH and Lac.</p><p><strong>Conclusion: </strong>Diameter variations in the ICA and MCA may indicate changes in vascular compliance and potential remodeling abnormalities. Hemodynamic anomalies in the ICA's initial segment could suggest distal vascular disease, offering new insights into cSVD pathogenesis.</p>\",\"PeriodicalId\":19422,\"journal\":{\"name\":\"Neuroradiology\",\"volume\":\" \",\"pages\":\"961-975\"},\"PeriodicalIF\":2.8000,\"publicationDate\":\"2025-04-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neuroradiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s00234-025-03569-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroradiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00234-025-03569-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/3 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Carotid artery hemodynamics and geometry as predictors of cerebral small vessel disease: insights from 4D flow imaging.
Background and purpose: Cerebral small vessel disease (cSVD) is a common condition with complex pathophysiology, resulting in poor clinical outcomes. This study uses four-dimensional flow (4D flow) imaging to examine how carotid artery hemodynamics and geometry impact cSVD development.
Methods: Combining ultrasound, 4D flow, and three-dimensional time-of-flight magnetic resonance angiography (3D-TOF MRA), we analyzed and measured internal carotid artery (ICA) hemodynamics and geometric parameters. Based on cranial magnetic resonance imaging (MRI) findings, the characteristics, counts, and scores of small vessel diseases were assessed. Single-factor analyses affecting cSVD were conducted, followed by multivariable logistic regression to pinpoint independent risk factors. A P-value of < 0.05 was considered statistically significant. ROC curves were used to evaluate the model's performance and explanatory power.
Results: Multivariable analysis revealed differences in white matter hyperintensities (WMH) related to maximum pressure gradient (PGmax), with an ORZscore of 1.602. Maximum velocity(velocitymax) negatively correlated with enlarged perivascular space (PVS) count (P = 0.025). ICA-C5/ICA initial segment diameter ratio, velocitymax, and PGmax were independent risk factors for lacune (Lac) (P < 0.01). Circumferential wall shear stress (WSSmean) and PGmax were positively correlated with cerebral microbleed (CMB) count (P = 0.019 and P = 0.002), while the ICA-C5/ICA ratio was negatively correlated (P = 0.003). The MCA/ICA-C5 diameter ratio was positively associated with SVD score (P = 0.021). ROC curves demonstrated strong model performance for WMH and Lac.
Conclusion: Diameter variations in the ICA and MCA may indicate changes in vascular compliance and potential remodeling abnormalities. Hemodynamic anomalies in the ICA's initial segment could suggest distal vascular disease, offering new insights into cSVD pathogenesis.
期刊介绍：
Neuroradiology aims to provide state-of-the-art medical and scientific information in the fields of Neuroradiology, Neurosciences, Neurology, Psychiatry, Neurosurgery, and related medical specialities. Neuroradiology as the official Journal of the European Society of Neuroradiology receives submissions from all parts of the world and publishes peer-reviewed original research, comprehensive reviews, educational papers, opinion papers, and short reports on exceptional clinical observations and new technical developments in the field of Neuroimaging and Neurointervention. The journal has subsections for Diagnostic and Interventional Neuroradiology, Advanced Neuroimaging, Paediatric Neuroradiology, Head-Neck-ENT Radiology, Spine Neuroradiology, and for submissions from Japan. Neuroradiology aims to provide new knowledge about and insights into the function and pathology of the human nervous system that may help to better diagnose and treat nervous system diseases. Neuroradiology is a member of the Committee on Publication Ethics (COPE) and follows the COPE core practices. Neuroradiology prefers articles that are free of bias, self-critical regarding limitations, transparent and clear in describing study participants, methods, and statistics, and short in presenting results. Before peer-review all submissions are automatically checked by iThenticate to assess for potential overlap in prior publication.
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