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Loss of venous integrity in cerebral small vessel disease: a 7-T MRI study in cerebral autosomal-dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL).
[cadasil]
Previous
pathological
studies
in
humans
or
in
animal
models
have
shown
alterations
of
small
arteries
and
veins
within
white
matter
lesions
in
cerebral
small
vessel
disease
.
We
aimed
to
evaluate
in
vivo
,
the
integrity
of
the
cerebral
venous
network
using
high
-resolution
MRI
both
within
and
outside
white
matter
hyperintensities
in
cerebral
autosomal-dominant
arteriopathy
with
subcortical
infarcts
and
leukoencephalopathy
(
CADASIL
)
.
High
-resolution
T
2
*
-
weighted
images
were
obtained
at
7
-
T
in
13
CADASIL
patients
with
no
or
only
mild
symptoms
and
13
age-
and
sex-matched
controls
.
Macroscopic
veins
were
automatically
counted
in
the
centrum
semiovale
and
compared
between
patients
and
controls
.
In
addition
,
T
2
*
was
compared
between
groups
in
the
normal-appearing
white
matter
.
Vein
density
was
found
lower
in
CADASIL
patients
compared
with
that
in
controls
(
-
14
.
6
%
in
patients
,
P
<
0
.
001
)
.
This
was
detected
both
within
and
outside
white
matter
hyperintensities
.
Mean
T
2
*
,
that
is
presumably
inversely
related
to
the
venous
density
,
was
also
found
increased
in
normal-appearing
white
matter
of
patients
(
+
7
.
2
%
,
P
=
0
.
006
)
.
All
results
were
independent
from
the
extent
of
white
matter
hyperintensities
.
A
significant
reduction
in
the
number
of
visible
veins
was
observed
in
the
centrum
semiovale
of
CADASIL
patients
both
within
and
outside
white
matter
hyperintensities
,
together
with
an
increase
of
T
2
*
in
the
normal-appearing
white
matter
.
Additional
studies
are
needed
to
decipher
the
exact
implication
of
such
vasculature
changes
in
the
appearance
of
white
matter
lesions
.