Grading and Interpretation of White Matter Hyperintensities Using Statistical Maps

Title
Grading and Interpretation of White Matter Hyperintensities Using Statistical Maps
Author(s)
이준Wi-Sun Ryu[Wi-Sun Ryu]Sung-Ho Woo[Sung-Ho Woo]Min Uk Jang[Min Uk Jang]Keun-Sik Hong[Keun-Sik Hong]Keun-Sik Hong[Keun-Sik Hong]Moo-Ku Han[Moo-Ku Han]Kyung Bok Lee[Kyung Bok Lee]Hee-Joon Bae[Hee-Joon Bae]Dong-Eog Kim[Dong-Eog Kim]
Keywords
VASCULAR RISK-FACTORS; SMALL VESSEL DISEASE; VOXEL-BASED ANALYSIS; BLOOD-PRESSURE; ACUTE STROKE; ENDOTHELIAL FUNCTION; ATRIAL-FIBRILLATION; ISCHEMIC-STROKE; LESIONS; VOLUME
Issue Date
201412
Publisher
LIPPINCOTT WILLIAMS & WILKINS
Citation
STROKE, v.45, no.12, pp.3567 - +
Abstract
Background and Purpose-We aimed to generate rigorous graphical and statistical reference data based on volumetric measurements for assessing the relative severity of white matter hyperintensities (WMHs) in patients with stroke. Methods-We prospectively mapped WMHs from 2699 patients with first-ever ischemic stroke (mean age=66.8 +/- 13.0 years) enrolled consecutively from 11 nationwide stroke centers, from patient (fluid-attenuated-inversion-recovery) MRIs onto a standard brain template set. Using multivariable analyses, we assessed the impact of major (age/hypertension) and minor risk factors on WMH variability. Results-We have produced a large reference data library showing the location and quantity of WMHs as topographical frequency-volume maps. This easy-to-use graphical reference data set allows the quantitative estimation of the severity of WMH as a percentile rank score. For all patients (median age=69 years), multivariable analysis showed that age, hypertension, atrial fibrillation, and left ventricular hypertrophy were independently associated with increasing WMH (0-9.4%, median=0.6%, of the measured brain volume). For younger (<= 69) hypertensives (n=819), age and left ventricular hypertrophy were positively associated with WMH. For older (>= 70) hypertensives (n=944), age and cholesterol had positive relationships with WMH, whereas diabetes mellitus, hyperlipidemia, and atrial fibrillation had negative relationships with WMH. For younger nonhypertensives (n=578), age and diabetes mellitus were positively related to WMH. For older nonhypertensives (n=328), only age was positively associated with WMH. Conclusions-We have generated a novel graphical WMH grading (Kim statistical WMH scoring) system, correlated to risk factors and adjusted for age/hypertension. Further studies are required to confirm whether the combined data set allows grading of WMH burden in individual patients and a tailored patient-specific interpretation in ischemic stroke-related clinical practice.
URI
http://hdl.handle.net/YU.REPOSITORY/30310http://dx.doi.org/10.1161/STROKEAHA.114.006662
ISSN
0039-2499
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의과대학 > 신경과학교실 > Articles
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