Correlation of Total Magnetic Resonance Imaging Burden with Middle Cerebral Artery Pulsatility Index in Elderly Patients with Cerebral Small Vessel Disease.

Cerebral small vessel disease (CSVD) is a prevalent, chronic, and progressive vascular disease. This study aimed to assess the predictive efficacy of the middle cerebral artery (MCA) pulsatility index (PI) for high magnetic resonance imaging (MRI) burden in elderly patients with CSVD. The study included 200 individuals, and transcranial Doppler (TCD), MRI, and clinical data were collected. Patients were divided into low-burden (0-1 points) and high-burden (2-4 points) groups according to the total MRI burden score. Univariate and multivariate logistic regression analyses and Spearman rank correlation analysis were used to assess the association between MCA PI and total MRI burden. The predictive value of MCA PI for high MRI burden in elderly patients with CSVD was assessed using receiver operating characteristic (ROC) curves. Multivariate logistic regression showed that, after adjustment for other confounding factors, MCA PI remained associated with total MRI burden (P < 0.001). Spearman rank correlation analysis showed that MCA PI was strongly correlated with the total MRI burden score in elderly patients with CSVD (rs = 0.583, P < 0.001). A cut-off value of 1.11 for MCA PI was optimal for predicting high MRI burden in elderly patients with CSVD, with an area under the curve (AUC) of 0.923 (P < 0.001, 95% CI: 0.851-0.927), a sensitivity of 0.864, and a specificity of 0.78. In conclusion, total MRI burden was positively associated with MCA PI in elderly patients with CSVD. MCA PI has high predictive value for high MRI burden in elderly patients with CSVD and may be useful for early screening and monitoring.