Imaging Study Of White Matter Hyperintensity In Patients With Acute Ischemic Stroke

Objective:To investigate the white matter hyperintensity in patients with acute ischemic stroke by MRI and further explore the factors associated with white matter hyperintensity and its relationship with acute ischemic stroke,in order to deeply understand the determinants of white matter hyperintensity in patients with acute ischemic stroke,and provide more basis for clinical prevention and treatment.Materials and methods:Patients with acute ischemic stroke included within 72 hours of onset were admitted to the hospital using a Siemens 3.0T magnetic resonance imaging system for routine MRI sequences（T₁WI,T₂WI,DWI,FLAIR）,MRA,and SWI.Based on axial T₂WI and T₂ FLAIR images,the semi-automatic volume segmentation method was used to measure the volume of white matter hyperintensity.To analyze the correlation between white matter hyperintensity and related vascular risk factors,infarct severity,infarct volume,infarct site,single and multiple infarcts and brain atrophy in patients with acute ischemic stroke,and further ex white matter hyperintensity anatomical distribution.Result:A total of 70 patients with acute ischemic stroke were included,with an average age of 61.3±11.1 years.Among them,40 were positive for white matter hyperintensity and 30 were negative.Compared with conventional T₂WI images.White matter hyperintensity volume measurement is more accurate based on T₂ FLAIR images（P<0.001）.The white matter hyperintensity lesions were divided into lesions,the lesions were most common in the frontal lobe（90%）,and the ratio of white matter hyperintensity at different sites was significantly different（P<0.001）.Compared with the white matter hyperintensity negative group,the average age of patients with white matter hyperintensity positive group was significantly larger（P=0.016）,and the older the age,the greater the volume of white matter hyperintensity（P=0.026）;factors such as hypertension（P=0.334）and history of coronary heart disease（P=0.114）were not significantly different between the two groups.There was no significant difference in the incidence of white matter hyperintensity in patients with different blood supply areas,such as the central branch of the middle cerebral artery（P=0.562）and the cerebral cortical branch of the anterior cerebral artery（P=0.503）.There was no significant difference in the incidence of white matter hyperintensity between patients with acute single and multiple infarction（P=0.636）,and no significant difference in the volume of white matter hyperintensity in patients with acute single and multiple infarcts in white matter hyperintensity positive patients（P=0.598）.In addition,patients with acute ischemic stroke with brain atrophy had a higher incidence of white matter hyperintensity（P=0.002）.Conclusion:In acute ischemic stroke patients,compared with conventional T₂WI,T₂FLAIR sequence can more accurately and clearly show the white matter hyperintensity of patients.Among many vascular risk factors,age is related to the rate of white matter hyperintensity,and the older it is,the larger the white matter hyperintensity volume is.Significant associations were not found between the infarct sites and the occurrence of white matter hyperintensities;and no significant differences in the incidence of white matter hyperintensities between patients with acute single and multiple infarctions were found.In patients with acute ischemic stroke,white matter hyperintensity are most likely to occur in the frontal lobe,and patients with brain atrophy are more likely to have white matter hyperintensity.