MRI Assessment of Cerebral Small Vessel Disease in Patients with Spontaneous Intracerebral Hemorrhage
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Purpose: Cerebral small vessel disease (SVD) is known to be associated with ischemic stroke, intracerebral hemorrhage (ICH), andcognitive impairment. In this retrospective observational study, we explored SVD markers on MRI relevant to spontaneous ICH. Materials and Methods: The ICH group consisted of 150 consecutive patients with a first primary parenchymal ICH, and the controlgroup consisted of 271 age- and sex-matched individuals who underwent brain MRI in a health care center. We compared cerebralmicrobleeds (CMBs), white matter hyperintensities (WMHs), enlarged perivascular space (EPVS), and lacunae in the ICHand control groups. Results: A total of 1278 CMB lesions were identified in 121 of the 150 patients in the ICH group (80.6%), while 77 CMB lesions werefound in 32 of the 271 individuals in the control group (11.8%). WMH and EPVS were more severe and lacunae were more frequentin the ICH patients than in the control group. When receiver operating characteristic (ROC) curves were plotted, number of CMBsmost significantly predicted ICH. All imaging markers were significantly associated with ICH in every age group. The location ofCMBs coincided with the location of ICH, and ICH volume correlated with CMB count. Conclusion: All MRI markers for SVD were worse in ICH patients than in healthy controls, and these markers were prominenteven in young ICH patients. Lacunae, WMH, EPVS, and CMB should be considered as factors related with spontaneous ICH.
Abstract
Purpose: Cerebral small vessel disease (SVD) is known to be associated with ischemic stroke, intracerebral hemorrhage (ICH), andcognitive impairment. In this retrospective observational study, we explored SVD markers on MRI relevant to spontaneous ICH. Materials and Methods: The ICH group consisted of 150 consecutive patients with a first primary parenchymal ICH, and the controlgroup consisted of 271 age- and sex-matched individuals who underwent brain MRI in a health care center. We compared cerebralmicrobleeds (CMBs), white matter hyperintensities (WMHs), enlarged perivascular space (EPVS), and lacunae in the ICHand control groups. Results: A total of 1278 CMB lesions were identified in 121 of the 150 patients in the ICH group (80.6%), while 77 CMB lesions werefound in 32 of the 271 individuals in the control group (11.8%). WMH and EPVS were more severe and lacunae were more frequentin the ICH patients than in the control group. When receiver operating characteristic (ROC) curves were plotted, number of CMBsmost significantly predicted ICH. All imaging markers were significantly associated with ICH in every age group. The location ofCMBs coincided with the location of ICH, and ICH volume correlated with CMB count. Conclusion: All MRI markers for SVD were worse in ICH patients than in healthy controls, and these markers were prominenteven in young ICH patients. Lacunae, WMH, EPVS, and CMB should be considered as factors related with spontaneous ICH.
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