MRI features of cerebral small vessel disease (CSVD), i.e. white matter hyperintensities, lacunes, microbleeds, perivascular spaces, and cerebral atrophy, may be associated with clinical events, but the strength of these associations remains unclear. We conducted a systematic review and meta-analysis on the association between these features and incident ischaemic and haemorrhagic stroke, all-cause dementia and depression, and all-cause mortality. For the association with stroke, 36 studies were identified (number of individuals/events [n] = 38,432/4,136), for dementia 28 (n = 16,458/1,709), for depression nine (n = 9,538/1,746), and for mortality 28 (n = 23,031/2,558). Only two studies evaluated perivascular spaces; these results were not pooled. Pooled analyses showed that all other features were associated with all outcomes (hazard ratios ranged 1.22–2.72). Combinations of two features were more strongly associated with stroke than any individual feature. Individual features and combinations of CSVD features are strongly associated with incident ischaemic and haemorrhagic stroke, all-cause dementia and depression, and all-cause mortality. If these associations are causal, the strength of these associations suggests that a substantial burden of disease is attributable to CSVD.

脑小血管病 (CSVD) 的 MRI 特征，即白质高信号、腔隙、微出血、血管周围间隙和脑萎缩，可能与临床事件有关，但这些关联的强度仍不清楚。我们对这些特征与缺血性和出血性卒中、全因痴呆和抑郁以及全因死亡率之间的关联进行了系统评价和荟萃分析。对于与中风的关联，确定了 36 项研究（个体/事件数 [n] = 38,432/4,136）、痴呆 28（n = 16,458/1,709）、抑郁症 9（n = 9,538/1,746）和死亡率28 (n = 23,031/2,558)。只有两项研究评估了血管周围间隙；这些结果没有汇总。汇总分析显示所有其他特征与所有结果相关（风险比范围为 1.22-2.72）。与任何单个特征相比，两个特征的组合与中风的相关性更强。CSVD 特征的个体特征和组合与缺血性和出血性卒中、全因痴呆和抑郁以及全因死亡率密切相关。如果这些关联是因果关系，那么这些关联的强度表明，大量的疾病负担可归因于 CSVD。