Abstract T P145: Physiological Parameters and Radiological Findings of Cerebral Small Vessel Disease

Background and Purpose: Lacunar infarction and intracerebral hemorrhage (ICH) are closely related. Although they are classified as different stroke subtypes, both are associated with cerebral small-vessel disease (CSVD). Previous studies showed a positive correlation of CSVD with physiological parameters such as pulse wave velocity (PWV) or with radiographical findings such as cerebral microbleeds (CMB); however, the role of these parameters remains controversial. Therefore, we assessed whether there is a relationship between stroke subtypes and these potential CSVD-related parameters. Methods: In a multicenter, prospective study from 8 hospitals, we enrolled 342 patients with a history of cerebral infarction or ICH who underwent both carotid ultrasound and MRI examination between February 2011 and December 2012. Ischemic stroke subtypes were determined based on the Trial of Org 10172 in Acute Stroke Treatment criteria, and patients with small vessel occlusion (SVO) or large artery atherosclerosis (LAA) were included in this study. We evaluated the PWV, ultrasonographic parameters [max-IMT, plaque score, pulsatility index (PI), and the diameter of common carotid artery (CCA)], and MRI findings [periventricular hyperintensity (PVH) and CMB]. The severity of PVH was determined according to the Fazekas classification. Results: Of 342 patients, 130 (38%) were classified into the LAA group, 64 (19%) into the ICH group, and 148 (43%) into the SVO group. There were no significant differences in the parameters between the SVO and ICH groups; however, the parameters of the SVO or ICH groups were different from those of the LAA group. After adjustment for vascular risk factors, the following parameters in both SVO and ICH groups were significantly different from those in the LAA group: lower plaque score, higher PI of the internal carotid artery (ICA), higher PVH grade, and greater CMB frequency. Conclusion: The SVO and ICH groups showed alterations in imaging parameters reflecting the underlying pathophysiology of CSVD, including lower plaque score, higher PI of ICA, greater CMB frequency, and higher PVH grade, compared with those of the LAA group.