An Investigation into White Matter Small Vessel Disease Using Susceptibility-Weighted and Perfusion Magnetic Resonance Imaging

Cerebral Small Vessel Disease (CSVD) is the most prevalent neurological condition among elderly adults and is associated with increased risk of stroke and dementia. CSVD manifests as regions of white matter hyperintensity on T2-weighted MRI. This thesis examines the role that susceptibility-weighted imaging (SWI) can play in understanding CSVD by developing an automated and quantitative procedure that isolates the venous anatomy. The prominence of veins as seen on SWI throughout white matter and also in areas not affected by the disease were found to be positively correlated with CSVD lesion burden. Furthermore, a shared anatomical correspondence between the lesions and the venous vasculature was found. The increased prominence of veins could reflect the pathophysiological changes associated with CSVD such as ischemia, hemodynamic impairment and venous collagenosis. The use of novel neuroimaging techniques to characterize CSVD can improve our current understanding and may be useful in monitoring and treating the disease.M.Sc