Objective To observe the efficacy and safety of 3 D video-assisted thoracoscopic segmentectomy in patients with stage Ⅰ lung cancer treated with indocyanine green(ICG)fluorescence reverse-staining.Methods A total of 132 patients with stage Ⅰ lung cancer who were admitted from May 2022 to September 2024 all underwent three-dimensional video-assisted thoracoscopic segmental resection of the lung.They were divided into the observation group(63 cases)and the control group(69 cases)according to the method of intersegmental plane exposure.The control group was treated with the modified expansion and collapse method,while the observation group was treated with the ICG fluorescence backstaining method.The surgical conditions,pulmonary function,postoperative pain degree,quality of life and complications of the two groups were compared.Results The postoperative chest tube retention time,surgical time,postoperative hospitalization time,total postoperative thoracic drainage volume,and inter-segmental plane exposure time in the observation group were as follows(2.13±0.37)d,(145.12±25.26)min,(5.21±0.95)d,(261.41±28.57)ml and(9.15±1.73)s,respectively.The data of the control groups were(3.29±0.48)d,(178.31±30.45)min,(6.34±1.36)d,(352.03±36.74)ml and(1 651.28±179.84)s,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the number of intraoperative blood loss and intraoperative lymph node dissections between the two groups(P＞0.05).There was no statistically significant difference in the levels of maximal expiratory flow(PEF),forced expiratory volume in one second(FEV1),and FEV1/forced vital capacity(FVC)between the two groups before the operation and one month after the operation(P＞0.05).The Visual Analogue Scale(VAS)scores of the observation group at 12 hours,48 hours and 72 hours after the operation were(3.25±0.46)points,(2.13±0.35)points and(1.02±0.24)points respectively.The control groups were(4.11±0.59)points,(2.98±0.42)points,and(1.73±0.30)points,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the scores of negative and positive items between the two groups before the operation and one month after the operation(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion The modified dilatation collapse method and ICG fluorescence reverse staining method have no significant effects on lung function and complications in patients with stage Ⅰ lung cancer,and both can improve the quality of life.Compared with the modified dilatation collapse method,ICG fluorescence reverse staining method can shorten the plane exposure time between segments and the operation time,promote postoperative rehabilitation and alleviate postoperative pain.

Objective To observe the value of quantitative parameters of synthetic MRI(syMRI)and multiplexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)for predicting pathological characteristics of endometrial cancer(EC).Methods Totally 125 patients with single EC were retrospectively collected.Quantitative parameters of EC,including T1,T2,proton density(PD)and apparent diffusion coefficient(ADC)values were measured based on preoperative syMRI and MUSE-DWI.Univariate analysis and multivariate logistic regression were performed to explore quantitative parameters of EC in order to screen independent predictors of EC with different pathologic characteristics for establishing combined models.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the predictive efficacy of models.Results Among 125 cases,type Ⅰ(estrogen-dependent type)and type Ⅱ(non-estrogen-dependent type)EC were found in 109 and 16 cases,respectively,including 94 cases of medium-low grade(31 of grade G1+63 of grade G2)and 31 cases of high grade(grade G3)EC,93 low-risk type(grade G1-2 type Ⅰ EC)and 32 high-risk type(grade G3 type Ⅰ EC+type Ⅱ EC),with muscular invasion＜1/2 in 84 cases and≥1/2 in 41 cases.Meanwhile,vascular infiltration was found in 41 cases.Lymph node invasion was detected in 18 cases but not in 105 cases,which remained unclear in 2 cases.T2 value of type Ⅰ EC was higher than that of type Ⅱ EC(P＜0.05).T2 and ADC values of high grade or high-risk type EC were lower than those of medium-low grade or low-risk type EC(all P＜0.05).T1,PD and ADC values of EC with muscular invasion≥1/2 were all lower than of those with muscular invasion＜1/2(all P＜0.05).No significant difference of other quantitative MRI parameters was observed among EC with different pathological features(all P＞0.05).ADC value was independent predictor of EC grade and risk type,PD and ADC values were both independent predictors of EC muscular invasion(all P＜0.05).The AUC of PD+ADC model for predicting muscular invasion depth of EC was 0.739,which was not significantly different with that of single PD and ADC models(0.692 and 0.707)(both P＞0.05).Conclusion Quantitative parameters of syMRI and MUSE-DWI could be used in clinical prediction of pathological characteristics of EC.

Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

Objective To observe the value of quantitative parameters of synthetic MRI(syMRI)and multiplexed sensitivity encoding diffusion weighted imaging(MUSE-DWI)for predicting pathological characteristics of endometrial cancer(EC).Methods Totally 125 patients with single EC were retrospectively collected.Quantitative parameters of EC,including T1,T2,proton density(PD)and apparent diffusion coefficient(ADC)values were measured based on preoperative syMRI and MUSE-DWI.Univariate analysis and multivariate logistic regression were performed to explore quantitative parameters of EC in order to screen independent predictors of EC with different pathologic characteristics for establishing combined models.Receiver operating characteristic curves were drawn,the area under the curves(AUC)were calculated to evaluate the predictive efficacy of models.Results Among 125 cases,type Ⅰ(estrogen-dependent type)and type Ⅱ(non-estrogen-dependent type)EC were found in 109 and 16 cases,respectively,including 94 cases of medium-low grade(31 of grade G1+63 of grade G2)and 31 cases of high grade(grade G3)EC,93 low-risk type(grade G1-2 type Ⅰ EC)and 32 high-risk type(grade G3 type Ⅰ EC+type Ⅱ EC),with muscular invasion＜1/2 in 84 cases and≥1/2 in 41 cases.Meanwhile,vascular infiltration was found in 41 cases.Lymph node invasion was detected in 18 cases but not in 105 cases,which remained unclear in 2 cases.T2 value of type Ⅰ EC was higher than that of type Ⅱ EC(P＜0.05).T2 and ADC values of high grade or high-risk type EC were lower than those of medium-low grade or low-risk type EC(all P＜0.05).T1,PD and ADC values of EC with muscular invasion≥1/2 were all lower than of those with muscular invasion＜1/2(all P＜0.05).No significant difference of other quantitative MRI parameters was observed among EC with different pathological features(all P＞0.05).ADC value was independent predictor of EC grade and risk type,PD and ADC values were both independent predictors of EC muscular invasion(all P＜0.05).The AUC of PD+ADC model for predicting muscular invasion depth of EC was 0.739,which was not significantly different with that of single PD and ADC models(0.692 and 0.707)(both P＞0.05).Conclusion Quantitative parameters of syMRI and MUSE-DWI could be used in clinical prediction of pathological characteristics of EC.

Objective This study aims to explore the efficacy and complication rates of the transcranial approach(TCA)and extended endoscopic endonasal approach(EEEA)for the treatment of craniopharyngiomas based on the QST classification,providing a scientific reference for clinical decision-making on surgical approach.Methods A total of 151 patients who underwent craniopharyngioma surgery at our center from January 2018 to December 2023 were enrolled.The patients were categorized into Q-CP(suprasellar type),S-CP(infundibular type),and T-CP(tuberal type)according to the QST classification.Systematic collection and analysis were performed on the outcomes of TCA and EEEA treatments,respectively.The differences in effectiveness between the two approaches were evaluated based on the QST classification.Results The improvement rate of visual symptoms was overall higher in the EEEA group than in the TCA group(59.1%vs.36.5%,P=0.006),and the visual deterioration rate was lower(3.0%vs.14.1%,P=0.006).However,the incidence of cerebrospinal fluid leakage was higher in the EEEA group(15.2%vs.3.5%,χ2=4.986,P=0.026).The incidence of postoperative seizures(8.2%vs.0,P=0.019),brain contusions(10.6%vs.0,P=0.005),and subdural hematoma(9.4%vs.0%,P=0.01)was higher in the TCA group.For patients with Q-CP type,the EEEA group had a higher rate of total tumor resection(92.9%vs.65.2%,P=0.025)and a lower recurrence rate(3.6%vs.21.7%,P=0.047),with shorter hospital stays and lower postoperative costs.The TCA group had higher intraoperative blood loss in this type(300 mL vs.200 mL,Z=-2.261,P=0.024).For S-CP type patients,the EEEA group showed a higher rate of total tumor resection(91.3%vs.74.2%)and a lower recurrence rate(0 vs.12.9%,P=0.031),with lower postoperative hospital costs.In T-CP type,due to the deeper location,EEEA showed limitations in protecting hypothalamic function and the TCA group had a better postoperative hypothalamic function score(P=0.035).Conclusion Based on QST classification,EEEA has advantages in Q-CP and S-CP types and is recommended as the preferred surgical procedure;In the T-CP type,TCA surgery is more helpful in protecting hypothalamic function.

Objective To investigate the correlation between enlarged perivascular spaces(EPVS)in different regions and glymphatic system(GS)function with cognitive function in patients with recent subcortical small infarction(RSSI).Methods A retrospective study was conducted by consecutively enrolling patients with RSSI who were hospitalized in the Department of Neurology at the Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People's Hospital)from December 2023 to December 2024.Baseline and clinical data were collected,including age,sex,body mass index(BMI),history of smoking and alcohol consumption,hypertension,diabetes mellitus,atrial fibrillation,coronary heart disease,and laboratory indicators(including homocysteine,total cholesterol,triglycerides,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,glycated hemoglobin,uric acid,and creatinine).Cognitive function was assessed within 7 d of onset using the mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scale,which covers seven cognitive domains:visuospatial and executive functioning,naming,attention,language,abstraction,memory,and orientation.All patients underwent brain MRI within 3 d of admission,including diffusion tensor imaging(DTI)sequences.The DTI along the perivascular space(DTI-ALPS)post-processing tool was used to calculate the DTI-ALPS index on both sides,and the mean value was taken as an indicator to evaluate overall GS function.The volumes of EPVS in the basal ganglia(BG)and centrum semiovale(CSO)were measured.EPVS severity was visually rated based on Potter's method(on a scale range from 0 to 4)and categorized into a none-to-mild(grades 0-1)and a moderate-to-severe(grades 2-4)group.Patients were further classified by region into a BG-EPVS and a CSO-EPVS subgroups under each severity group.(1)Univariate analyses were performed to compare baseline characteristics,DTI-ALPS index,and cognitive assessment scores between groups.Variables with P＜0.05 in univariate analyses were tested for multicollinearity using variance inflation factor.Variables without multicollinearity were included in multivariate Logistic regression to identify independent factors associated with BG-EPVS.To assess the robustness of the predictive value of the DTI-ALPS index,outlier diagnostics and exclusion were performed,followed by re-estimation of the Logistic regression model.Spearman's correlation analysis was used to examine the associations of BG-EPVS volume with the DTI-ALPS index,MMSE scale score,MoCA scale score,and each cognitive domain score.Mediation analysis was conducted to evaluate whether the DTI-ALPS index mediated the relationship between BG-EPVS volume and MoCA scale score.Results A total of 65 RSSI patients were included in the study,comprising 34 males and 3 1 females,aged 37 to 78 years,with a mean age of(53±15)years.Among them,30 patients were classified into the none-to-mild EPVS group and 35 into the moderate-to-severe EPVS group.For regional classification,34 were in the none-to-mild BG-EPVS group and 31 in the moderate-to-severe BG-EPVS group;36 were in the none-to-mild CSO-EPVS group and 29 in the moderate-to-severe CSO-EPVS group.(1)Univariate analysis showed,in both overall EPVS and BG-EPVS subgroup,the none-to-mild groups had lower age,lower proportions of male and hypertensive patients,and higher DTI-ALPS indices,MMSE scale scores,and MoCA scale scores than the moderate-to-severe groups(all P＜0.05).No significant differences were found in other baseline or clinical characteristics(all P＞0.05).In the CSO-EPVS subgroup,age was the only variable differed significantly between the none-to-mild group(significantly younger)and the moderate-to-severe group(P＜0.05),no other variables showed significant differences between the groups(all P＞0.05).(2)No multicollinearity was found among age,sex,hypertension,and the DTI-ALPS index through the multicollinearity analysis.Multivariate Logistic regression identified older age(OR,4.410,95％CI 1.211-16.025,P=0.024),male(OR,1.076,95％CI 1.001-1.156,P=0.048),and hypertension(OR,6.287,95％CI 1.635-24.167,P=0.007)as independent risk factors for moderate-to-severe BG-EPVS in RSSI patients,while a higher DTI-ALPS index was an independent protective factor(OR,0.002,95％CI 0.000-0.904,P=0.046).To assess the robustness of this model,six outlier cases were identified and excluded.After reanalysis,the negative association between the DTI-ALPS index and BG-EPVS risk remained significant(OR,0.050,95％CI 0.003-0.974,P=0.048).(3)Spearman correlation analysis revealed that the BG-EPVS volume in RSSI patients was negatively correlated with the DTI-ALPS index(rs=-0.842,P=0.007),MMSE scale score(rs=-0.491,P=0.033),MoCA scale score(rs=-0.563,P=0.018),and visuospatial/executive function score(rs=-0.596,P=0.001).No significant correlations were found between BG-EPVS volume and other cognitive domains,including naming,attention,language,abstraction,memory,and orientation(all P＞0.05).(4)Mediation analysis showed that the total effect size of BG-EPVS volume on MoCA scale score was-0.673,with a direct effect size of-0.537(account for 79.79％of the total effect size)and an indirect effect size via the DTI-ALPS index of-0.136(account for 20.21％).Conclusions In RSSI patients,age,sex,hypertension,and the DTI-ALPS index were identified as independent factors associated with the severity of BG-EPVS.BG-EPVS volume was negatively correlated with the DTI-ALPS index and cognitive function scores in RSSI patients.Moreover,the DTI-ALPS index mediated the relationship between BG-EPVS volume and cognitive function in RSSI patients.

Objective To investigate the correlation between enlarged perivascular spaces(EPVS)in different regions and glymphatic system(GS)function with cognitive function in patients with recent subcortical small infarction(RSSI).Methods A retrospective study was conducted by consecutively enrolling patients with RSSI who were hospitalized in the Department of Neurology at the Third Affiliated Hospital of Nanjing Medical University(Changzhou Second People's Hospital)from December 2023 to December 2024.Baseline and clinical data were collected,including age,sex,body mass index(BMI),history of smoking and alcohol consumption,hypertension,diabetes mellitus,atrial fibrillation,coronary heart disease,and laboratory indicators(including homocysteine,total cholesterol,triglycerides,low-density lipoprotein cholesterol,high-density lipoprotein cholesterol,glycated hemoglobin,uric acid,and creatinine).Cognitive function was assessed within 7 d of onset using the mini-mental state examination(MMSE)and Montreal cognitive assessment(MoCA)scale,which covers seven cognitive domains:visuospatial and executive functioning,naming,attention,language,abstraction,memory,and orientation.All patients underwent brain MRI within 3 d of admission,including diffusion tensor imaging(DTI)sequences.The DTI along the perivascular space(DTI-ALPS)post-processing tool was used to calculate the DTI-ALPS index on both sides,and the mean value was taken as an indicator to evaluate overall GS function.The volumes of EPVS in the basal ganglia(BG)and centrum semiovale(CSO)were measured.EPVS severity was visually rated based on Potter's method(on a scale range from 0 to 4)and categorized into a none-to-mild(grades 0-1)and a moderate-to-severe(grades 2-4)group.Patients were further classified by region into a BG-EPVS and a CSO-EPVS subgroups under each severity group.(1)Univariate analyses were performed to compare baseline characteristics,DTI-ALPS index,and cognitive assessment scores between groups.Variables with P＜0.05 in univariate analyses were tested for multicollinearity using variance inflation factor.Variables without multicollinearity were included in multivariate Logistic regression to identify independent factors associated with BG-EPVS.To assess the robustness of the predictive value of the DTI-ALPS index,outlier diagnostics and exclusion were performed,followed by re-estimation of the Logistic regression model.Spearman's correlation analysis was used to examine the associations of BG-EPVS volume with the DTI-ALPS index,MMSE scale score,MoCA scale score,and each cognitive domain score.Mediation analysis was conducted to evaluate whether the DTI-ALPS index mediated the relationship between BG-EPVS volume and MoCA scale score.Results A total of 65 RSSI patients were included in the study,comprising 34 males and 3 1 females,aged 37 to 78 years,with a mean age of(53±15)years.Among them,30 patients were classified into the none-to-mild EPVS group and 35 into the moderate-to-severe EPVS group.For regional classification,34 were in the none-to-mild BG-EPVS group and 31 in the moderate-to-severe BG-EPVS group;36 were in the none-to-mild CSO-EPVS group and 29 in the moderate-to-severe CSO-EPVS group.(1)Univariate analysis showed,in both overall EPVS and BG-EPVS subgroup,the none-to-mild groups had lower age,lower proportions of male and hypertensive patients,and higher DTI-ALPS indices,MMSE scale scores,and MoCA scale scores than the moderate-to-severe groups(all P＜0.05).No significant differences were found in other baseline or clinical characteristics(all P＞0.05).In the CSO-EPVS subgroup,age was the only variable differed significantly between the none-to-mild group(significantly younger)and the moderate-to-severe group(P＜0.05),no other variables showed significant differences between the groups(all P＞0.05).(2)No multicollinearity was found among age,sex,hypertension,and the DTI-ALPS index through the multicollinearity analysis.Multivariate Logistic regression identified older age(OR,4.410,95％CI 1.211-16.025,P=0.024),male(OR,1.076,95％CI 1.001-1.156,P=0.048),and hypertension(OR,6.287,95％CI 1.635-24.167,P=0.007)as independent risk factors for moderate-to-severe BG-EPVS in RSSI patients,while a higher DTI-ALPS index was an independent protective factor(OR,0.002,95％CI 0.000-0.904,P=0.046).To assess the robustness of this model,six outlier cases were identified and excluded.After reanalysis,the negative association between the DTI-ALPS index and BG-EPVS risk remained significant(OR,0.050,95％CI 0.003-0.974,P=0.048).(3)Spearman correlation analysis revealed that the BG-EPVS volume in RSSI patients was negatively correlated with the DTI-ALPS index(rs=-0.842,P=0.007),MMSE scale score(rs=-0.491,P=0.033),MoCA scale score(rs=-0.563,P=0.018),and visuospatial/executive function score(rs=-0.596,P=0.001).No significant correlations were found between BG-EPVS volume and other cognitive domains,including naming,attention,language,abstraction,memory,and orientation(all P＞0.05).(4)Mediation analysis showed that the total effect size of BG-EPVS volume on MoCA scale score was-0.673,with a direct effect size of-0.537(account for 79.79％of the total effect size)and an indirect effect size via the DTI-ALPS index of-0.136(account for 20.21％).Conclusions In RSSI patients,age,sex,hypertension,and the DTI-ALPS index were identified as independent factors associated with the severity of BG-EPVS.BG-EPVS volume was negatively correlated with the DTI-ALPS index and cognitive function scores in RSSI patients.Moreover,the DTI-ALPS index mediated the relationship between BG-EPVS volume and cognitive function in RSSI patients.

Deep medullary veins(DMVs)are critical components of the cerebral medullary venous system,responsible for venous drainage of the deep cerebral white matter.Recent research indicates that DMVs are closely related to cerebral small vessel disease(CSVD)and associated cognitive disorders.The morphological structure of DMVs can be clearly visualized on susceptibility weighted imaging and quantitative susceptibility mapping,which could potentially serve as markers for assessing the severity of CSVD.This article reviewed the anatomical characteristics and physiological functions of DMVs,as well as the mechanistic correlations between DMVs and various CSVD imaging markers,aiming to provide novel theoretical insights for early diagnosis and clinical management of CSVD.

Objective To observe the efficacy and safety of 3 D video-assisted thoracoscopic segmentectomy in patients with stage Ⅰ lung cancer treated with indocyanine green(ICG)fluorescence reverse-staining.Methods A total of 132 patients with stage Ⅰ lung cancer who were admitted from May 2022 to September 2024 all underwent three-dimensional video-assisted thoracoscopic segmental resection of the lung.They were divided into the observation group(63 cases)and the control group(69 cases)according to the method of intersegmental plane exposure.The control group was treated with the modified expansion and collapse method,while the observation group was treated with the ICG fluorescence backstaining method.The surgical conditions,pulmonary function,postoperative pain degree,quality of life and complications of the two groups were compared.Results The postoperative chest tube retention time,surgical time,postoperative hospitalization time,total postoperative thoracic drainage volume,and inter-segmental plane exposure time in the observation group were as follows(2.13±0.37)d,(145.12±25.26)min,(5.21±0.95)d,(261.41±28.57)ml and(9.15±1.73)s,respectively.The data of the control groups were(3.29±0.48)d,(178.31±30.45)min,(6.34±1.36)d,(352.03±36.74)ml and(1 651.28±179.84)s,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the number of intraoperative blood loss and intraoperative lymph node dissections between the two groups(P＞0.05).There was no statistically significant difference in the levels of maximal expiratory flow(PEF),forced expiratory volume in one second(FEV1),and FEV1/forced vital capacity(FVC)between the two groups before the operation and one month after the operation(P＞0.05).The Visual Analogue Scale(VAS)scores of the observation group at 12 hours,48 hours and 72 hours after the operation were(3.25±0.46)points,(2.13±0.35)points and(1.02±0.24)points respectively.The control groups were(4.11±0.59)points,(2.98±0.42)points,and(1.73±0.30)points,respectively.There was a statistically significant difference between the two groups(P＜0.05).There was no statistically significant difference in the scores of negative and positive items between the two groups before the operation and one month after the operation(P＞0.05).There was no statistically significant difference in the total incidence of complications between the two groups(P＞0.05).Conclusion The modified dilatation collapse method and ICG fluorescence reverse staining method have no significant effects on lung function and complications in patients with stage Ⅰ lung cancer,and both can improve the quality of life.Compared with the modified dilatation collapse method,ICG fluorescence reverse staining method can shorten the plane exposure time between segments and the operation time,promote postoperative rehabilitation and alleviate postoperative pain.

Deep medullary veins(DMVs)are critical components of the cerebral medullary venous system,responsible for venous drainage of the deep cerebral white matter.Recent research indicates that DMVs are closely related to cerebral small vessel disease(CSVD)and associated cognitive disorders.The morphological structure of DMVs can be clearly visualized on susceptibility weighted imaging and quantitative susceptibility mapping,which could potentially serve as markers for assessing the severity of CSVD.This article reviewed the anatomical characteristics and physiological functions of DMVs,as well as the mechanistic correlations between DMVs and various CSVD imaging markers,aiming to provide novel theoretical insights for early diagnosis and clinical management of CSVD.