Quantitative Study Of White Matter Lesions In Lacunar Infarct Patients

BackgroundWhite matter lesions (WML) and lacunar infarcts(LI) are two kinds ofcerebral small vessel diseases (SVD) with common major risk factors suchas aging and hypertension. They have imaging manifestations correlation.However, it has not been studied whether the WML is more severe in theipsilateral hemisphere of LI. We conducted this study to contrast the WMLvolume between the LI ipsilateral and contralateral hemisphere.MethodsRetrospectively, we collected the consecutively admitted acute lacunarstoke patients, confirmed by Clinical manifestations and magneticresonance imaging (MRI) features, between May2011and December2012at the Department of Neurology of the Second Affiliated Hospital ofChongqing Medical University. Clinical data, such as: sex、age、history ofsmoking drinking、hypertension、hyperglycemia、and blood lipoids wascollected and the LI ipsilateral and contralateral WML volume weremeasured with a semiautomated technique assisted by computer software.Firstly, the significant statistical differences were verified between the bilateral WML volume. Secondly, according to the bilateral WML volume,we divided all the cases into two groups: ipsilateral dominant group andipsilateral non-dominant group, and analyzed their common vascular riskfactors. At last, We compared the differences between the sum of thebilateral WML volume and the double of the LI contralateral WML volumeto assess the reliability of calculating the overall WML volume by the latermethod.ResultsThrough the strict inclusion and exclusion criterias, a total of101cases included in the study.①.The median of LI ipsilateral andcontralateral WML volume respectively were3.80mm3(interquartile range,1.69-8.70mm3) and2.96mm3(interquartile range,1.42-8.85mm3). Thebilateral WML volume were significantly different(P＜0.05).②.therewere no significant differences in common vascular risk factors betweenthe LI ipsilateral dominant(70cases) and non-dominant(31cases) group.③.The median of the sum of the bilateral WML volume and the double ofcontralateral WML volume respectively respectively were7.04mm3(interquartile range,3.21-17.38mm3) and7.60mm3(interquartile range,3.38-17.54mm3). Their differences were statistically significant (P=0.001).ConclusionWML is more severe in the ipsilateral cerebral hemisphere of acute LI. Aging and hypertension are not the risk factors leading to the WMLvolume differences of the two sides. More accurate methods are urgentlyneeded to quantify the overall WML volume in unilateral stroke patients.