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White matter hyperintensity in ischemic stroke patients: it may regress over time.

Cho AH, Kim HR, Kim W, Yang DW - J Stroke (2015)

Bottom Line: A statistical analysis was performed on the pattern of WMH change over time and factors associated with change.A multiple logistic regression model showed that age (odds ratio[OR] 2.51, 90% confidence interval[CI] 1.056-5.958), male gender (OR 2.957, 95% CI 1.051-9.037), large vessel disease (OR 1.955, 95% CI 1.171-3.366), and renal dysfunction (OR 2.900, 90% CI 1.045-8.046) were associated with progression.Regarding regression, no significant factor was found in the multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.

ABSTRACT

Background and purpose: White matter hyperintensities (WMH) are frequently observed on MRI in ischemic stroke patients as well as in normal elderly individuals. Besides the progression of WMH, the regression of WMH has been rarely reported. Thus, we aimed to investigate how WMH change over time in patients with ischemic stroke, particularly focusing on regression.

Methods: We enrolled ischemic stroke patients who underwent brain MRI more than twice with at least a 6 month time-interval. Based on T2-weighted or FLAIR MRI, WMH were visually assessed, followed by semiautomatic volume measurement. Progression or regression of WMH change was defined when 0.25 cc increase or decrease was observed and it was also combined with visible change. A statistical analysis was performed on the pattern of WMH change over time and factors associated with change.

Results: A total of 100 patients were enrolled. Their age (mean±SD) was 67.5±11.8 years and 63 were male. The imaging time-interval (mean) was 28.0 months. WMH progressed in 27, regressed in 9 and progressed in distinctive regions and regressed in others in 5 patients. A multiple logistic regression model showed that age (odds ratio[OR] 2.51, 90% confidence interval[CI] 1.056-5.958), male gender (OR 2.957, 95% CI 1.051-9.037), large vessel disease (OR 1.955, 95% CI 1.171-3.366), and renal dysfunction (OR 2.900, 90% CI 1.045-8.046) were associated with progression. Regarding regression, no significant factor was found in the multivariate analysis.

Conclusions: In 21.5% of ischemic stroke patients, regression of WMH was observed. WMH progression was observed in a third of ischemic stroke patients.

No MeSH data available.


Related in: MedlinePlus

A 72-year-old female presented with left pontine infarction (A). Regression of white matter hyperintensity is observed on T2-weighted MRI at 7 months of follow-up (B, initial scan; C, follow-up).
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Figure 3: A 72-year-old female presented with left pontine infarction (A). Regression of white matter hyperintensity is observed on T2-weighted MRI at 7 months of follow-up (B, initial scan; C, follow-up).

Mentions: On the initial MRI scan, WMH was observed in 65 patients. During the follow-up period, 27 patients showed progression of WMH (Figure 1) and 9 showed regression (Figures 2, 3). In 5 patients, both progression and regression were observed. Table 1 shows the clinical characteristics of patients with regression of WMH. Three patients among those without WMH on the initial scan had newly developed WMH on the follow-up scan. The initial WMH volume (median and interquartile range) was 2.78 cc (0.77-11.57). The volume difference in patients with progression was 3.32 cc (0.92-4.05) and that in patients with regression was -1.87 cc (-4.61- -0.73).


White matter hyperintensity in ischemic stroke patients: it may regress over time.

Cho AH, Kim HR, Kim W, Yang DW - J Stroke (2015)

A 72-year-old female presented with left pontine infarction (A). Regression of white matter hyperintensity is observed on T2-weighted MRI at 7 months of follow-up (B, initial scan; C, follow-up).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4325632&req=5

Figure 3: A 72-year-old female presented with left pontine infarction (A). Regression of white matter hyperintensity is observed on T2-weighted MRI at 7 months of follow-up (B, initial scan; C, follow-up).
Mentions: On the initial MRI scan, WMH was observed in 65 patients. During the follow-up period, 27 patients showed progression of WMH (Figure 1) and 9 showed regression (Figures 2, 3). In 5 patients, both progression and regression were observed. Table 1 shows the clinical characteristics of patients with regression of WMH. Three patients among those without WMH on the initial scan had newly developed WMH on the follow-up scan. The initial WMH volume (median and interquartile range) was 2.78 cc (0.77-11.57). The volume difference in patients with progression was 3.32 cc (0.92-4.05) and that in patients with regression was -1.87 cc (-4.61- -0.73).

Bottom Line: A statistical analysis was performed on the pattern of WMH change over time and factors associated with change.A multiple logistic regression model showed that age (odds ratio[OR] 2.51, 90% confidence interval[CI] 1.056-5.958), male gender (OR 2.957, 95% CI 1.051-9.037), large vessel disease (OR 1.955, 95% CI 1.171-3.366), and renal dysfunction (OR 2.900, 90% CI 1.045-8.046) were associated with progression.Regarding regression, no significant factor was found in the multivariate analysis.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurology, College of Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea.

ABSTRACT

Background and purpose: White matter hyperintensities (WMH) are frequently observed on MRI in ischemic stroke patients as well as in normal elderly individuals. Besides the progression of WMH, the regression of WMH has been rarely reported. Thus, we aimed to investigate how WMH change over time in patients with ischemic stroke, particularly focusing on regression.

Methods: We enrolled ischemic stroke patients who underwent brain MRI more than twice with at least a 6 month time-interval. Based on T2-weighted or FLAIR MRI, WMH were visually assessed, followed by semiautomatic volume measurement. Progression or regression of WMH change was defined when 0.25 cc increase or decrease was observed and it was also combined with visible change. A statistical analysis was performed on the pattern of WMH change over time and factors associated with change.

Results: A total of 100 patients were enrolled. Their age (mean±SD) was 67.5±11.8 years and 63 were male. The imaging time-interval (mean) was 28.0 months. WMH progressed in 27, regressed in 9 and progressed in distinctive regions and regressed in others in 5 patients. A multiple logistic regression model showed that age (odds ratio[OR] 2.51, 90% confidence interval[CI] 1.056-5.958), male gender (OR 2.957, 95% CI 1.051-9.037), large vessel disease (OR 1.955, 95% CI 1.171-3.366), and renal dysfunction (OR 2.900, 90% CI 1.045-8.046) were associated with progression. Regarding regression, no significant factor was found in the multivariate analysis.

Conclusions: In 21.5% of ischemic stroke patients, regression of WMH was observed. WMH progression was observed in a third of ischemic stroke patients.

No MeSH data available.


Related in: MedlinePlus