Clinical Study On Imaging Features Of Non-disabling Ischemic Cerebrovascular Events With Cerebral Small-vessel Disease

Objective:The purpose of this study was to investigate the clinical characteristics and imaging differences of cerebral small-vessel disease between high-risk patients(HR-NICE)and non-high-risk patients in non-disabling ischemic cerebrovascular events(NICE),and to provide evidence for finding the correlation between NICE and CSVD and the imaging differences of CSVD in different NICE populations.Methods:A total of 314 NICE patients hospitalized in the Department of Neurology,Taiyuan Central Hospital from September 2019 to December 2021 were selected as the study subjects.Those who met the HR-NICE diagnostic criteria in the guidelines were classified as the HR-NICE group;otherwise,they were classified as the non-HR-NICE group.The general clinical data and laboratory examination results of all patients were collected,as well as the imaging data of cerebral small-vessel disease such as lacuna,white matter hyperintensity,cerebral microbleed and perivascular space presented by cranial magnetic resonance were collected.Clinical data,laboratory results,lacuna,WMH,CMB,PVS and CSVD total load score were compared and analyzed between the two groups.Results:1.There were statistically significant differences in age between HR-NICE group and non-HR-NICE group(P < 0.05),and there were statistically significant differences in incidence of hypertension and diabetes between the two groups(P < 0.05).2.Compared with the non-HR-NICE group,the levels of D-dimer in peripheral blood of HR-NICE group were higher(P < 0.05),but there were no significant differences in WBC,hematocrit,TC,TG,HDL and fibrinogen between the two groups(P > 0.05).3.Compared with the non-HR-NICE group,the HR-NICE group had higher detection rates of lacuna,paraventricular WMH and deep WMH(P< 0.05),while there was no significant difference between the two groups in PVS and CMB(P > 0.05).There was significant difference in CSVD total load score between the two groups(P < 0.01).4.Multivariate Logistic regression analysis was conducted on the variables with statistically significant differences in univariate analysis,and the results showed that CSVD score on cranial imaging(OR: 1.748,95% confidence interval:1.325-2.306,P <0.01)is an independent risk factor of HR-NICE.Conclusion:1.Compared with non-HR-NICE patients,HR-NICE patients were older and had a higher prevalence of traditional stroke risk factors such as hypertension and diabetes.2.HR-NICE patients had higher D-dimer levels than non-HR-NICE patients.3.Compared with the normal population,NICE patients had a higher rate of imaging findings of CSVD,Compared with the non-HR-NICE group,HR-NICE patients had a higher rate of imaging manifestations of CSVD,and HR-NICE patients had a higher rate of lacuna and WMH.4.HR-NICE patients had a higher CSVD total load score than non-HR-NICE patients,and the CSVD total load score was an independent risk factor for HR-NICE,suggesting that a high CSVD total load score,hypertension,diabetes mellitus,and D-dimer have the potential to jointly evaluate the detection of HR-NICE populations for precise prevention and control.