White matter hyperintensity in ischemic stroke patients: it may regress over time.
White matter hyperintensity in ischemic stroke patients: it may regress over time.
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DOI：
10.5853/jos.2015.17.1.60
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发表时间：
2015-01
影响因子：
8.2
通讯作者：
Yang DW
中科院分区：
文献类型：
--
作者：
Cho AH;Kim HR;Kim W;Yang DW
白质高强度（WMH）在缺血性脑卒中患者和正常老年人的MRI上经常被观察到。除了WMH的进展外，WMH的消退很少有报道。因此，我们的目的是研究缺血性卒中患者WMH随时间的变化，特别是关注回归。我们招募了至少间隔6个月接受两次以上脑MRI检查的缺血性脑卒中患者。基于t2加权或FLAIR MRI，视觉评估WMH，然后进行半自动体积测量。当观察到0.25 cc增加或减少时，定义WMH变化的进展或倒退，并结合可见变化。统计分析了WMH随时间变化的模式和与变化相关的因素。共有100名患者入组。年龄（平均±SD）为67.5±11.8岁，男性63例。影像学时间间隔（平均）28.0个月。27例WMH进展，9例消退，5例在特定区域进展，其他区域消退。多元logistic回归模型显示，年龄（优势比[OR] 2.51, 90%可信区间[CI] 1.056-5.958）、男性（OR 2.957, 95% CI 1.051-9.037）、大血管疾病（OR 1.955, 95% CI 1.171-3.366）和肾功能障碍（OR 2.900, 90% CI 1.045-8.046）与进展相关。回归方面，多变量分析未发现显著因素。21.5%的缺血性脑卒中患者WMH出现倒退。在三分之一的缺血性卒中患者中观察到WMH进展。
White matter hyperintensities (WMH) are frequently observed on MRI in ischemic stroke patients as well as in normal elderly individuals. Besides the progression of WMH, the regression of WMH has been rarely reported. Thus, we aimed to investigate how WMH change over time in patients with ischemic stroke, particularly focusing on regression. We enrolled ischemic stroke patients who underwent brain MRI more than twice with at least a 6 month time-interval. Based on T2-weighted or FLAIR MRI, WMH were visually assessed, followed by semiautomatic volume measurement. Progression or regression of WMH change was defined when 0.25 cc increase or decrease was observed and it was also combined with visible change. A statistical analysis was performed on the pattern of WMH change over time and factors associated with change. A total of 100 patients were enrolled. Their age (mean±SD) was 67.5±11.8 years and 63 were male. The imaging time-interval (mean) was 28.0 months. WMH progressed in 27, regressed in 9 and progressed in distinctive regions and regressed in others in 5 patients. A multiple logistic regression model showed that age (odds ratio[OR] 2.51, 90% confidence interval[CI] 1.056-5.958), male gender (OR 2.957, 95% CI 1.051-9.037), large vessel disease (OR 1.955, 95% CI 1.171-3.366), and renal dysfunction (OR 2.900, 90% CI 1.045-8.046) were associated with progression. Regarding regression, no significant factor was found in the multivariate analysis. In 21.5% of ischemic stroke patients, regression of WMH was observed. WMH progression was observed in a third of ischemic stroke patients.
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DOI：
10.1136/bmj.c3666
发表时间：
2010-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Debette S;Markus HS
通讯作者：
Markus HS
影响因子：
3.5
作者：
Minguez, B.;Rovira, A.;Cordoba, J.
通讯作者：
Cordoba, J.
影响因子：
8.3
作者：
Wardlaw, JM;Sandercock, PAG;Starr, J
通讯作者：
Starr, J
影响因子：
8.3
作者：
Longstreth, WT;Arnold, AM;Furberg, CD
通讯作者：
Furberg, CD
影响因子：
8.3
作者：
Steinicke, Robert;Gaertner, Beate;Jungehulsing, Gerhard Jan
通讯作者：
Jungehulsing, Gerhard Jan