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This study investigated CP volume (CPV) alterations and their association with conventional imaging markers in CSVD and explored the underlying role of inflammation using ultrasmall superparamagnetic particles of iron oxide (USPIO)\u2010enhanced MRI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this study, 111 CSVD patients and 69 healthy controls (HC) underwent 3.0\u2009T conventional MRI to quantify CPV in the lateral (LV), third (3\u2009V), and fourth (4\u2009V) ventricles. CSVD burden was evaluated using visual assessment scales, including indicators such as white matter hyperintensities (WMH), lacunes, basal ganglia\u2010enlarged perivascular spaces (BG\u2010EPVS), cerebral microbleeds (CMBs), and brain atrophy (BA). A subgroup (22 CSVD, 10 HC) underwent USPIO\u2010enhanced MRI to measure the change of signal intensity ratio (\u2206SIR) as a feature of inflammatory activity in the CP and deep gray matter nuclei.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      CSVD patients showed significantly larger CPV (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). CPV demonstrated significant positive correlations with the severity of conventional CSVD imaging markers (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). USPIO\u2010enhanced MRI revealed an increased \u0394SIR in the LV, 3\u2009V, and 4\u2009V CP (all\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). Furthermore, increased USPIO uptake was observed in deep gray matter nuclei in CSVD. Crucially, a positive correlation was found between LV CP volume and \u0394SIR (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.375,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.034), and the LV CP inflammation was strongly correlated with the hippocampus (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u20090.582,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interpretation<\/jats:title>\n                    <jats:p>CP enlargement is prominent in CSVD and closely linked to the CSVD imaging burden. CP inflammation is associated with increased volume. CP may be a novel biomarker to help diagnose, monitor, and treat neuroinflammation in CSVD.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acn3.70382","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T04:11:01Z","timestamp":1775448661000},"page":"2078-2087","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Choroid Plexus Enlargement and\n                    <scp>USPIO<\/scp>\n                    \u2010Based Inflammatory Feature in Cerebral Small Vessel Disease"],"prefix":"10.1002","volume":"13","author":[{"given":"Yongqiang","family":"Qu","sequence":"first","affiliation":[{"name":"Department of Neurology and Institute of Neurology of First Affiliated Hospital Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University  Fuzhou 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Capital Medical University  Beijing China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhongmeng","family":"Lai","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Fujian Medical University Union Hospital  Fuzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2659-9376","authenticated-orcid":false,"given":"Bin","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Neurology and Institute of Neurology of First Affiliated Hospital Institute of Neuroscience, and Fujian Key Laboratory of Molecular Neurology, Fujian Medical University  Fuzhou China"},{"name":"Department of Neurology National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University  Fuzhou 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