Evolution Of Magnetic Resonance Imaging And Risk Factors In Patients With Lacunar Cerebral Infarction

Background and ObjectiveThe proportion of lacunar infarction caused by cerebrovascular disease in Chinese is significantly higher than that in Caucasian,about 20-46%.On MRI,the manifestations of cerebrovascular diseases are lacunes,white matter lesions,short-term subcortical small infarcts,intracerebral hemorrhage and brain atrophy.It is known that white matter hyperintensity has a causal relationship with dementia,and lacunes can also lead to cognitive decline,both of which are considered to be important causes of cognitive impairment.With the progress of the disease,the risk of stroke recurrence and death increases.Asymptomatic progression is a typical feature of lacunar infarction,so it is a potential serious disease,thus increasing the burden of disease on patients and their families.At present,the proportion of the lesions of symptomatic lacunar cerebral infarction evolving into cavities and the influencing factors are not the same,the sample size of the study is small,and there is no statistics of Chinese population.The changes in the diameter of new lacunar infarction,the proportion of cavity and white matter lesions and the influencing factors were analyzed by follow-up MRI.Materials and methodsFrom January 1,2013 to May 31,2018,160 patients(112 males and 48 females)with acute cerebral infarction(maximum lesion diameter<20 mm)were selected from the Second Affiliated Hospital and the Fifth Affiliated Hospital of Zhengzhou University.The diameter of the lesions was measured on DWI sequence.The patients were reexamined on FLAIR sequence to determine whether there was cavity.Then on T2 sequence,the diameter of the lesions was measured and four different outcomes were defined:complete cavitation(lacune),partial cavitation,white matter lesion and disappearance.The t test is used for continuous numerical variables which are in accordance with normal distribution and have homogeneity of variance,and the U test is used for significant skew distribution.Single factor analysis of variance was used to compare the mean of multiple groups.Rank sum test was used for rank data.Chi square test was used for categorical variables,and binary or multivariate logistic regression analysis was used for variables with P<0.05 to determine the influencing factors of the outcome.Spss22.0 software was used for analysis.Results1.In follow-up MRI,20(12.5%)had lacune,23(14.4%)had partial cavitation,97(60.6%)had white matter lesions,and 20(12.5%)had disappeared.2.The difference between the formation of lacune and hypertension was statistically significant(P=0.026).Binary logistic regression analysis showed that the two were closely related(B=-1.056 OR=0.348 95%CI 0.133-0.909),suggesting that hypertension was negatively related to the formation of lacune.3.Binary logistic regression analysis showed that cavity formation was negatively correlated with diabetes mellitus(B=-0.950,OR=0.387,95%CI 0.168-0.892)and diameter change(B=-0.117,OR=0.889,95%CI 0.794-0.996).ConclusionsAbout a quarter of the patients with symptomatic lacunar cerebral infarction had cavities on MRI.Hypertension was negatively correlated with lacune formation,while diabetes mellitus and diameter change were negatively correlated with cavity formation.