Abstract
BACKGROUND AND PURPOSE: Cerebral amyloid angiopathy (CAA) is a leading cause of intracranial hemorrhage and cognitive decline in the elderly. This study seeks to investigate the quantitative MRA features as new markers of CAA. MATERIALS AND METHODS: In this cross-sectional study, consecutive patients with CAA and controls who underwent 3D time-of-flight MRA were included. Demographic and clinical data, including sex, age, diabetes, smoking, hypertension, and atrial fibrillation, were collected. Radiologic features, including the microhemorrhage classification, siderosis, and Fazekas scale, were also collected. Using in-house developed semiautomated software (VesselVoyager), quantitative MRA features, including total arterial length, number of branches, and tortuosity, were extracted. Univariable and multivariable logistic regression analyses were then performed to compare the CAA and non-CAA cohorts. RESULTS: Seventy-four patients were included: 43 with CAA and 31 controls. Quantitative MRA analysis showed that patients with CAA had significantly reduced total arterial length (1900 ± 1240 mm versus 2880 ± 1540 mm; P = .006). Univariable logistic regression identified total arterial length (P = .009), age (P = .012), and total branch number (P = .107) as relevant predictors of CAA. In multivariable analysis, total arterial length (OR: 0.95; 95% CI: 0.92-0.99; P = .014) and age (OR: 1.06; 95% CI: 1.01-1.12; P = .023) remained independently associated with CAA diagnosis. CONCLUSIONS: Quantitative MRA total arterial length is inversely, independently, and significantly associated with CAA diagnosis. This could potentially serve as an imaging marker of CAA diagnosis and potentially further elucidate vascular segment involvement in patients with CAA.