Relationship Between Transcranial Doppler Pulsatility Index And Leukoaraiosis Detected By Magnetic Resonance Imaging

Background and Purpose—Cerebral leukoaraiosis (LA) represent a subclinical form of small vessel disease which has been associated with risk of cognitive decline, depression and future stroke. Studies have shown an association between microangiopathy and transcranial doppler (TCD) pulsatility index (PI) in several kinds of patients. The aim of this study was to evaluate the relationship between middle cerebral artery PI (MCA-PI) and the severity of LA detected by magnetic resonance imaging (MRI). Method—We register consecutively patients who were adimitted to the neurological department of China-Japan friendship hospital and had accepted TCD and cranial MRI examination. We also recorded their vascular risk factors such as obesity, hypertension, diabete, hypercholesterolemia, tobacco use and plasma total homocysteine level. MCA-PI was calculated by averaging the MCA PI at a depth of 50 to 60mm of both temporal windows. A summary score of LA was calculated for each patient.by summing the periventricualr hyperintensity (PVH) and deep white matter hyperintensity (DWMH) for both hemispheres. Result—42 patients were included, their age, MCA PI and LA score were associated .significantly with each other. The patients with. hypertension had more severe LA than the patients without. For the patients with hypertension, MCA PI was still related significantly to LA score after controlling age, but for the patients without hypertension was not. Multivariate linear regression analysis indicated that the only significant factor able to predict the severity of LA in patients with hypertension was MCA PI. Conclusion—PI shows strong correlation with age. MCA PI can independently predict the severity of LA in patients with hypertension. TCD PI may reflect small vessel disease in brain to some extent.