The value of magnetic resonance QSM in assessing the severity of cerebral small vessel disease with microbleeds and its relationship with cognitive impairment

WANG Qingqing; WANG Shaoying; WANG Hongjing; ZHAO Minjian

doi:10.20258/j.cnki.1006-9011.2025.05.005

Abstract：Objective To explore the parameter levels of quantitative magnetic resonance imaging(QSM)in patients with cerebral small vessel disease(CSVD)complicated with cerebral microbleeds(CMB),and its relationship with the severity of cognitive dysfunction.Methods A total of 270 patients with CSVD combined with CMB were selected.Based on the severity of CMB,patients were divided into a severe group(n=92)and a non-severe group(n=178).We compared the general clinical data of patients in two groups,collected MoCA scores from all patients,collected QSM parameters of thalamus,putamen,and hippo-campus from all patients,analyzed the relationship between patient magnetic resonance QSM parameters and cognitive impair-ment using Pearson analysis,and identified the influencing factors on the severity of CMB in CSVD patients with logistic regres-sion analysis.Moreover,receiver operating characteristic(ROC)curves and area under the curve(AUC)were used to evaluate the value of QSM parameters in thalamus,putamen,and hippocampus magnetic resonance imaging was used for assessing the se-verity of CMB in CSVD patients.Results Compared with non-severe patients,the age and proportion of hypertensive patients in the severe group increased(P<0.05).Compared with non-severe group patients,the QSM parameter levels of thalamus,puta-men,and hippocampus in severe group patients were all elevated(P<0.05).Compared with non-severe group patients,the MoCA score of severe group patients decreased(P<0.05).The correlation analysis results showed that the QSM parameter levels of thala-mus,putamen,and hippocampus in patients were negatively correlated with MoCA scores(P<0.05).The results of logistic regres-sion analysis showed that high levels of QSM parameters in hypertension,age,thalamus,putamen,and hippocampus were risk factors for severe cognitive dysfunction in CSVD patients(P<0.05).The ROC curve analysis results showed that the diagnostic value of the combined QSM parameters of thalamus,putamen,and hippocampus for the severity of CMB in CSVD patients was higher than that evaluated separately(all P<0.01).Conclusion The changes in QSM parameters of thalamus,putamen,and hippocampus in CSVD patients are not only closely related to the severity of CMB,but to cognitive impairment as well.