Separation of vascular and nonvascular components in the white matter lesion in cerebral small vessel disease

Motivation: White matter lesion (WML) is a neuroimaging signature of cerebral small vessel disease (CSVD), commonly comprising both vascular and nonvascular components for which assessment methods remain to be developed. Goal(s): To investigate the feasibility of using multimodal MR imaging to separate vascular and nonvascular components in WML. Approach: Twelve patients with CSVD were prospectively included and underwent 3T MR imaging. Magnetization transfer ratio (MTR) was derived from magnetization transfer imaging. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were derived from diffusion tensor imaging. Results: MTR was found to correlate with ADC and FA differently in WML as compared to normal-appearing white matter. Impact: Appropriate separation of vascular/nonvascular components in WML can help differential diagnosis and treatment formation of CSVD. The sensitivity of combined MTR/FA/ADC can be further verified by comparing CSVD with other neurological diseases that present WML but have nonvascular pathogenesis.