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Association between remote diffusion‐weighted imaging lesions and cerebral small vessel disease in primary intracerebral hemorrhage
Author(s) -
Xu X.h.,
Ye X.h.,
Li J.w.,
Cai J.s.,
Gao T.,
Zhang W.j.,
Zhao G.h.,
Tong L.s.,
Gao F.
Publication year - 2019
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13915
Subject(s) - medicine , odds ratio , confidence interval , hyperintensity , intracerebral hemorrhage , magnetic resonance imaging , logistic regression , univariate analysis , white matter , multivariate analysis , radiology , subarachnoid hemorrhage
Background and purpose The aim of this study was to examine the association amongst remote diffusion‐weighted imaging lesions (R‐ DWIL s), imaging markers of cerebral small vessel disease ( cSVD ) and total cSVD burden in patients with primary intracerebral haemorrhage ( ICH ). Methods In total, 344 consecutive primary ICH patients were enrolled prospectively. R‐ DWIL s on magnetic resonance imaging as well as four imaging markers of cSVD , including cerebral microbleeds ( CMB s), white matter hyperintensities ( WMH s), lacunes and enlarged perivascular spaces, were rated with validated scales. The total cSVD score was calculated by adding up these four markers. Univariate and multivariate analyses were performed. Results Remote DWI lesions were detected in 57 (16.6%) primary ICH patients. On multivariate logistic regression analysis, the presence of CMB s [odds ratio ( OR ) 5.26, 95% confidence interval ( CI ) 1.72–16.12], of high‐grade WMH s ( OR 4.68, 95% CI 2.01–10.90), the presence of lacunes ( OR 2.69, 95% CI 1.20–6.06), mixed CMB s ( OR 2.93, 95% CI 1.35–6.36), mixed lacunes ( OR 3.60, 95% CI 1.25–10.37), periventricular WMH s ( OR 2.19, 95% CI 1.40–3.44), deep WMH s ( OR 1.92, 95% CI 1.24–2.97) and total WMH s ( OR 1.52, 95% CI 1.20–1.94) were associated with the presence of R‐ DWIL s. A significant association was also found between high‐grade total cSVD score and R‐ DWIL s ( OR 1.97, 95% CI 1.36–2.84). This association remained significant in patients stratified by an age of 60 years or more than 60 years. Conclusions Remote DWI lesions are correlated with the severity of each imaging marker of cSVD and with the total burden of cSVD .