Summarizing the multiplicity and heterogeneity of cerebrovascular disease (CVD) features into a single measure has been difficult in both neuropathology and imaging studies. The objective of this work was to evaluate the association between neuroimaging surrogates of CVD and two available neuropathologic CVD scales in those with both antemortem imaging CVD measures and postmortem CVD evaluation. Individuals in the Mayo Clinic Study of Aging with MRI scans within 5 years of death (N = 51) were included. Antemortem CVD measures were computed from diffusion MRI (dMRI), FLAIR, and T2* GRE imaging modalities and compared with postmortem neuropathologic findings using Kalaria and Strozyk Scales. Of all the neuroimaging measures, both regional and global dMRI measures were associated with Kalaria and Strozyk Scales (p < 0.05) and modestly correlated with global cognitive performance. The major conclusions from this study were: (i) microstructural white matter injury measurements using dMRI may be meaningful surrogates of neuropathologic CVD scales, because they aid in capturing diffuse (and early) changes to white matter and secondary neurodegeneration due to lesions; (ii) vacuolation in the corpus callosum may be associated with white matter changes measured on antemortem dMRI imaging; (iii) Alzheimer’s disease neuropathologic change did not associate with neuropathologic CVD scales; and (iv) future work should be focused on developing better quantitative measures utilizing dMRI to optimally assess CVD-related neuropathologic changes.

在神经病理学和影像学研究中，将脑血管疾病 (CVD) 特征的多样性和异质性总结为单一的测量方法一直很困难。这项工作的目的是评估 CVD 的神经影像学替代指标与两种可用的神经病理学 CVD 量表之间的关联，这些量表同时具有生前影像学 CVD 测量和死后 CVD 评估。 包括在死亡后 5 年内进行 MRI 扫描的 Mayo Clinic 老龄化研究中的个体（N = 51）。生前 CVD 措施是根据弥散 MRI (dMRI)、FLAIR 和 T2* GRE 成像模式计算的，并与使用 Kalaria 和 Strozyk 量表的死后神经病理学结果进行比较。在所有神经影像学测量中，区域和全球 dMRI 测量均与 Kalaria 和 Strozyk 量表相关（p  < 0.05)，并与整体认知表现适度相关。这项研究的主要结论是：（i）使用 dMRI 进行的微观结构白质损伤测量可能是神经病理学 CVD 量表的有意义的替代指标，因为它们有助于捕获白质的弥漫性（和早期）变化和病变引起的继发性神经变性；(ii) 胼胝体中的空泡形成可能与生前 dMRI 成像测量的白质变化有关；(iii) 阿尔茨海默病神经病理学变化与神经病理学 CVD 量表无关；(iv) 未来的工作应侧重于利用 dMRI 开发更好的定量措施，以最佳地评估 CVD 相关的神经病理学变化。