{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:52:41Z","timestamp":1780991561366,"version":"3.54.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"},{"start":{"date-parts":[[2024,3,1]],"date-time":"2024-03-01T00:00:00Z","timestamp":1709251200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"General Research Fund","award":["14106019"],"award-info":[{"award-number":["14106019"]}]},{"name":"Direct Grant for Research, Chinese University of Hong Kong","award":["2020.033"],"award-info":[{"award-number":["2020.033"]}]},{"name":"Early Career Scheme","award":["24103122"],"award-info":[{"award-number":["24103122"]}]},{"name":"Li Ka Shing Institute of Health Sciences"},{"DOI":"10.13039\/501100003802","name":"Research Grants Council of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003802","id-type":"DOI","asserted-by":"publisher"}]},{"name":"General Research Fund","award":["14106019"],"award-info":[{"award-number":["14106019"]}]},{"name":"Direct Grant for Research, Chinese University of Hong Kong","award":["2020.033"],"award-info":[{"award-number":["2020.033"]}]},{"name":"Early Career Scheme","award":["24103122"],"award-info":[{"award-number":["24103122"]}]},{"name":"Li Ka Shing Institute of Health Sciences"},{"DOI":"10.13039\/501100003802","name":"Research Grants Council of Hong Kong","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003802","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2024,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Cerebral small vessel disease (CSVD) commonly exists in patients with symptomatic intracranial atherosclerotic disease (sICAD). We aimed to investigate the associations of hemodynamic features of sICAD lesions with imaging markers and overall burden of CSVD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patients and methods:<\/jats:title>\n                    <jats:p>Patients with anterior-circulation sICAD (50%\u201399% stenosis) were analyzed in this cross-sectional study. Hemodynamic features of a sICAD lesion were quantified by translesional pressure ratio (PR\u2009=\u2009Pressurepost-stenotic\/Pressurepre-stenotic) and wall shear stress ratio (WSSR\u2009=\u2009WSSstenotic-throat\/WSSpre-stenotic) via CT angiography-based computational fluid dynamics modeling. PR \u2a7dmedian was defined as low (\u201cabnormal\u201d) PR, and WSSR\u2009\u2a7e\u2009fourth quartile as high (\u201cabnormal\u201d) WSSR. For primary analyses, white matter hyperintensities (WMHs), lacunes, and cortical microinfarcts (CMIs) were assessed in MRI and summed up as overall CSVD burden, respectively in ipsilateral and contralateral hemispheres to sICAD. Enlarged perivascular spaces (EPVSs) and cerebral microbleeds (CMBs) were assessed for secondary analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among 112 sICAD patients, there were more severe WMHs, more lacunes and CMIs, and more severe overall CSVD burden ipsilaterally than contralaterally (all p\u2009&amp;lt;\u20090.05). Abnormal PR and WSSR (vs normal PR and WSSR) was significantly associated with moderate-to-severe WMHs (adjusted odds ratio\u2009=\u200910.12, p\u2009=\u20090.018), CMI presence (5.25, p\u2009=\u20090.003), and moderate-to-severe CSVD burden (12.55; p\u2009=\u20090.033), ipsilaterally, respectively independent of contralateral WMHs, CMI(s), and CSVD burden. EPVSs and CMBs were comparable between the two hemispheres, with no association found with the hemodynamic metrics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion and conclusion:<\/jats:title>\n                    <jats:p>There are more severe WMHs and CMI(s) in the hemisphere ipsilateral than contralateral to sICAD. The hemodynamic significance of sICAD lesions was independently associated with severities of WMHs and CMI(s) ipsilaterally.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/23969873231205669","type":"journal-article","created":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T08:38:27Z","timestamp":1696581507000},"page":"144-153","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Hemodynamic significance of intracranial atherosclerotic disease and ipsilateral imaging markers of cerebral small vessel disease"],"prefix":"10.1093","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1501-0351","authenticated-orcid":false,"given":"Lina","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"},{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuan","family":"Tian","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jill","family":"Abrigo","sequence":"additional","affiliation":[{"name":"Department of Imaging and Interventional Radiology, Chinese University of Hong Kong, Hong Kong SAR, China 3"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bonaventure YM","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7105-5311","authenticated-orcid":false,"given":"Yuying","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yu","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linfang","family":"Lan","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"},{"name":"Department of Neurology, First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China 5"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haipeng","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"},{"name":"Research Centre for Intelligent Healthcare, Faculty of Health and Life Sciences, Coventry University, Coventry, UK 6"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hing Lung","family":"Ip","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florence SY","family":"Fan","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sze Ho","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5933-9290","authenticated-orcid":false,"given":"Alexander Y","family":"Lau","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannie OY","family":"Soo","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Howan","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent CT","family":"Mok","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lawrence KS","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuming","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Neurology, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China 4"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liping","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China 2"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinyi","family":"Leng","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas W","family":"Leung","sequence":"additional","affiliation":[{"name":"Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong SAR, China 1"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,3,1]]},"reference":[{"key":"2026012113092614700_bibr1-23969873231205669","doi-asserted-by":"crossref","first-page":"602","DOI":"10.1016\/S1474-4422(23)00131-X","article-title":"Neuroimaging standards for research into small vessel disease-advances since 2013","volume":"22","author":"Duering","year":"2023","journal-title":"Lancet Neurol"},{"key":"2026012113092614700_bibr2-23969873231205669","doi-asserted-by":"crossref","first-page":"2857","DOI":"10.1161\/STROKEAHA.118.022485","article-title":"Practical small vessel disease score relates to stroke, dementia, and death","volume":"49","author":"Yilmaz","year":"2018","journal-title":"Stroke"},{"key":"2026012113092614700_bibr3-23969873231205669","doi-asserted-by":"crossref","first-page":"609607","DOI":"10.3389\/fneur.2020.609607","article-title":"Intracranial atherosclerosis coexisting with white matter hyperintensities may predict unfavorable functional outcome in patients with acute cerebral ischemia","volume":"11","author":"Liu","year":"2020","journal-title":"Front Neurol"},{"key":"2026012113092614700_bibr4-23969873231205669","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1159\/000319574","article-title":"Coexisting small vessel disease predicts poor long-term outcome in stroke patients with intracranial large artery atherosclerosis","volume":"30","author":"Fu","year":"2010","journal-title":"Cerebrovasc Dis"},{"key":"2026012113092614700_bibr5-23969873231205669","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1001\/jamaneurol.2015.3145","article-title":"Frequency, risk factors, and outcome of coexistent small vessel disease and intracranial arterial stenosis","volume":"73","author":"Kwon","year":"2016","journal-title":"JAMA Neurol"},{"key":"2026012113092614700_bibr6-23969873231205669","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1161\/HYPERTENSIONAHA.109.133116","article-title":"Large and small artery cross-talk and recent morbidity-mortality trials in hypertension","volume":"54","author":"Laurent","year":"2009","journal-title":"Hypertension"},{"key":"2026012113092614700_bibr7-23969873231205669","doi-asserted-by":"crossref","first-page":"483","DOI":"10.1016\/S1474-4422(13)70060-7","article-title":"Mechanisms of sporadic cerebral small vessel disease: insights from neuroimaging","volume":"12","author":"Wardlaw","year":"2013","journal-title":"Lancet Neurol"},{"key":"2026012113092614700_bibr8-23969873231205669","doi-asserted-by":"crossref","first-page":"163","DOI":"10.3389\/fnagi.2020.00163","article-title":"The asymmetry of white matter hyperintensity burden between hemispheres is associated with intracranial atherosclerotic plaque enhancement grade","volume":"12","author":"Ni","year":"2020","journal-title":"Front Aging Neurosci"},{"key":"2026012113092614700_bibr9-23969873231205669","doi-asserted-by":"crossref","first-page":"e2932","DOI":"10.1002\/brb3.2932","article-title":"White matter hyperintensities had a correlation with the cerebral perfusion level, but no correlation with the severity of large vessel stenosis in the anterior circulation","volume":"13","author":"Feng","year":"2023","journal-title":"Brain Behav"},{"key":"2026012113092614700_bibr10-23969873231205669","doi-asserted-by":"crossref","first-page":"730","DOI":"10.1016\/S1474-4422(17)30196-5","article-title":"Detection, risk factors, and functional consequences of cerebral microinfarcts","volume":"16","author":"van Veluw","year":"2017","journal-title":"Lancet Neurol"},{"key":"2026012113092614700_bibr11-23969873231205669","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1002\/ana.25456","article-title":"Hemodynamics and stroke risk in intracranial atherosclerotic disease","volume":"85","author":"Leng","year":"2019","journal-title":"Ann Neurol"},{"key":"2026012113092614700_bibr12-23969873231205669","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1177\/0271678X18805209","article-title":"Sustaining cerebral perfusion in intracranial atherosclerotic stenosis: the roles of antegrade residual flow and leptomeningeal collateral flow","volume":"40","author":"Lan","year":"2018","journal-title":"J Cereb Blood Flow Metab"},{"key":"2026012113092614700_bibr13-23969873231205669","doi-asserted-by":"crossref","first-page":"351","DOI":"10.2214\/ajr.149.2.351","article-title":"MR signal abnormalities at 1.5 T in Alzheimer\u2019s dementia and normal aging","volume":"149","author":"Fazekas","year":"1987","journal-title":"Am J Roentgenol"},{"key":"2026012113092614700_bibr14-23969873231205669","doi-asserted-by":"crossref","first-page":"1760","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.04.002","article-title":"Cortical microinfarcts in patients with middle cerebral artery stenosis","volume":"26","author":"Leng","year":"2017","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2026012113092614700_bibr15-23969873231205669","doi-asserted-by":"crossref","first-page":"1135","DOI":"10.1161\/STROKEAHA.117.020130","article-title":"Intracranial arterial dolichoectasia and stenosis","volume":"49","author":"Zhai","year":"2018","journal-title":"Stroke"},{"key":"2026012113092614700_bibr16-23969873231205669","doi-asserted-by":"crossref","first-page":"2690","DOI":"10.1177\/0271678X211011288","article-title":"Cerebral cortical microinfarcts in patients with internal carotid artery occlusion","volume":"41","author":"van den Brink","year":"2021","journal-title":"J Cereb Blood Flow Metab"},{"key":"2026012113092614700_bibr17-23969873231205669","doi-asserted-by":"crossref","first-page":"639","DOI":"10.1161\/STROKEAHA.118.023781","article-title":"Cortical cerebral microinfarcts on 3T magnetic resonance imaging in patients with carotid artery stenosis","volume":"50","author":"Takasugi","year":"2019","journal-title":"Stroke"},{"key":"2026012113092614700_bibr18-23969873231205669","doi-asserted-by":"crossref","first-page":"214","DOI":"10.3389\/fneur.2020.00214","article-title":"Hemodynamic significance of middle cerebral artery stenosis associated with the severity of ipsilateral white matter changes","volume":"11","author":"Fang","year":"2020","journal-title":"Front Neurol"},{"key":"2026012113092614700_bibr19-23969873231205669","doi-asserted-by":"crossref","first-page":"779","DOI":"10.1161\/CIRCULATIONAHA.111.021824","article-title":"Coronary artery wall shear stress is associated with progression and transformation of atherosclerotic plaque and arterial remodeling in patients with coronary artery disease","volume":"124","author":"Samady","year":"2011","journal-title":"Circulation"},{"key":"2026012113092614700_bibr20-23969873231205669","doi-asserted-by":"crossref","first-page":"2379","DOI":"10.1161\/STROKEAHA.107.484766","article-title":"Plaque rupture in the carotid artery is localized at the high shear stress region","volume":"38","author":"Groen","year":"2007","journal-title":"Stroke"},{"key":"2026012113092614700_bibr21-23969873231205669","doi-asserted-by":"crossref","first-page":"1146","DOI":"10.1212\/WNL.0000000000007654","article-title":"CNS small vessel disease","volume":"92","author":"Cannistraro","year":"2019","journal-title":"Neurology"},{"key":"2026012113092614700_bibr22-23969873231205669","doi-asserted-by":"crossref","first-page":"1475","DOI":"10.1001\/archneur.55.11.1475","article-title":"Impaired clearance of emboli (washout) is an important link between hypoperfusion, embolism, and ischemic stroke","volume":"55","author":"Caplan","year":"1998","journal-title":"Arch Neurol"},{"key":"2026012113092614700_bibr23-23969873231205669","doi-asserted-by":"publisher","DOI":"10.1007\/s12975-023-01146-4","article-title":"Cerebral hemodynamics underlying artery-to-artery embolism in symptomatic intracranial atherosclerotic disease","author":"Feng","year":"2023","journal-title":"Transl Stroke Res"},{"key":"2026012113092614700_bibr24-23969873231205669","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1111\/j.1750-3639.2012.00575.x","article-title":"Pathology of lacunar ischemic stroke in humans-a systematic review","volume":"22","author":"Bailey","year":"2012","journal-title":"Brain Pathol"}],"container-title":["European Stroke Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/23969873231205669","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/23969873231205669","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/academic.oup.com\/esj\/article-pdf\/9\/1\/144\/64647173\/23969873231205669.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/esj\/article-pdf\/9\/1\/144\/64647173\/23969873231205669.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T18:10:16Z","timestamp":1769019016000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/esj\/article\/9\/1\/144\/8268983"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,1]]},"references-count":24,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,3,1]]}},"URL":"https:\/\/doi.org\/10.1177\/23969873231205669","relation":{},"ISSN":["2396-9873","2396-9881"],"issn-type":[{"value":"2396-9873","type":"print"},{"value":"2396-9881","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,3,1]]},"published":{"date-parts":[[2024,3,1]]}}}