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

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.