Title:Diffusion-weighted Imaging Detection of Acute Ischemia Brain Lesions in Spontaneous Intracerebral Hemorrhage Associated with White Matter
Hyperintensities, Enlarged Perivascular Spaces and Diabetes Mellitus
Volume: 20
Issue: 5
Author(s): Yutong Hou, Wei Qin, Shuna Yang, Yue Li, Lei Yang and Wenli Hu*
Affiliation:
- Department of Neurology, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
Keywords:
Spontaneous intracerebral hemorrhage, diffusion-weighted imaging lesion, white matter hyperintensities, enlarged perivascular spaces, diabetes mellitus, non-traumatic bleeding.
Abstract: Objective: Diffusion-weighted imaging (DWI) is commonly detected after spontaneous
intracerebral hemorrhage (sICH) and is associated with poor functional outcomes. However,
the etiology and significance of DWI lesions remain unclear. Thus, our study aimed to explore
the prevalence and risk factors of acute ischemic lesions in sICH and discussed the possible
mechanisms.
Methods: We conducted a retrospective review of a consecutive cohort of 408 patients from
June 2013 to October 2019 with sICH, who had brain computed tomography (CT) and magnetic
resonance imaging (MRI) within 14 days of symptoms onset. Acute ischemic lesions were assessed
on MRI using DWI lesions. We compared the clinical and imaging characteristics of patients
with and without DWI lesions. The data were analyzed by univariate and multivariate logistic
regression.
Results: Among the enrolled 408 patients, the mean age was 56.8 ± 14.5 years, 68 (16.7%) of
them had been diagnosed with diabetes mellitus (DM). DWI lesions were observed in 89
(21.8%) patients, and most of them had a history of lacunar infarctions, which were located in
cortical or subcortical. In multivariate logistic regression analysis, DM (odds ratio (OR) 3.962, p
<0.001), severe deep white matter hypertensities (DWMH) (OR 2.463, p =0.001) and severe
centrum semiovale enlarged perivascular spaces (CSO-EPVS) (OR 2.679, p =0.001) were independently
associated with the presence of DWI lesions.
Conclusion: In our cohort, we found DM, severe DWMH and severe CSO-EPVS were the independent
risk factors in sICH patients with DWI lesions.
