Objective:

To explore the diagnostic relevance of in-vivo juxtacortical perivascular spaces (jPVS) burden with cerebral amyloid angiopathy (CAA) on 5.0T MRI.

Background:

JPVS was observed in CAA and associated with the histopathological severity. However, the diagnostic relevance between in vivo jPVS and CAA remains undetermined.

Design/Methods:

A total of 117 consecutive participants who underwent 5.0T MRI were retrospectively enrolled [48 probable CAA diagnosed according to the Bonston v1.5 criteria and 69 hypertension-related cerebral vessel disease (HTN-CSVD)]. The jPVS burden was evaluated using a newly proposed visual rating scale. Established CAA imaging markers were assessed according to the STRIVE criteria, including centrum semiovale perivascular spaces (CSO-PVS), lobar intracerebral hemorrhage (ICH), lobar cerebral microbleeds (CMBs), and cortical superficial siderosis (cSS). Multivariable logistic regression and ROC analyses were used to assess whether the total jPVS burden was associated with the diagnosis of CAA. Generalized linear models were used to evaluate the association between jPVS and established CAA markers.

Results:

The jPVS were presented in both CAA and HTN-CSVD, with a significantly higher burden in CAA compared to HTN-CSVD (p < 0.001). Participants in the highest tertile of total jPVS burden had an increased odds of CAA diagnosis compared to those in the lowest tertile (OR = 14.93, 95% CI: 4.59-48.53, p < 0.001), after adjusting for age, sex, hypertension, diabetes, and hyperlipidemia. The total jPVS number discriminated CAA well from HTN-CSVD (AUC: 0.799, P < 0.001). Moreover, the jPVS burden independently correlated with severe CSO-PVS, lobar ICH, lobar CMBs, the presence of cSS, and cSS extent (all P <0.05).

Conclusions: