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Grading and interpretation of white matter hyperintensities using statistical maps.

Wi-Sun Ryu1, Sung-Ho Woo1, Dawid Schellingerhout1

  • 1From the Stroke Center and Korean Brain MRI Data Center, Dongguk University Ilsan Hospital, Goyang, Korea (W.-S.R., S.-H.W., S.-W.J., J.-Y.N., D.-E.K.); Department of Radiology, University of Texas M. D. Anderson Cancer Center, Houston (D.S.); Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison (M.K.C.); WeBace Co, Ltd, Busan, Korea (K.-J.P.); Department of Neurology, Seoul National University Hospital, Seoul, Korea (C.K.K.); Department of Neurology, Chuncheon Sacred Heart Hospital, Chuncheon, Korea (M.U.J.); Department of Neurology, Ilsan Paik Hospital, Goyang, Korea (K.-S.H., Y.-J.C.); Department of Neurology, Chonnam National University Hospital, Gwangju, Korea (K.-H.C., J.-T.K.); Department of Neurology, Seoul National University Bundang Hospital, Seongnam, Korea (B.J.K., M.-K.H., H.-J.B.); Department of Neurology, Yeungnam University Hospital, Daegu, Korea (J.L.); Department of Neurology, Dong-A University Hospital, Busan, Korea (J.-K.C., D.-H.K.); Department of Neurology, Eulji University Hospital, Daejeon, Korea (S.J.L., Y.K.); Department of Neurology, Hallym University Sacred Heart Hospital, Anyang, Korea (B.-C.L., K.-H.Y., M.-S.O.); Department of Neurology, Eulji General Hospital, Seoul, Korea (J.-M.P., K.K.); Department of Neurology, Soonchunhyang University Hospital, Seoul, Korea (K.B.L.); Department of Neurology, Seoul Medical Center, Seoul, Korea (T.H.P.); Department of Biostatistics, Korea University College of Medicine, Seoul, Korea (J.L.); Department of Computer Science, Inje University, Busan, Korea (H.-K.C.); and Departments of Neurology and Neurosurgery, The University of Texas Health Science Center, Houston (K.L.).

Stroke
|November 13, 2014
PubMed
Summary

This study created a new graphical system to assess white matter hyperintensities (WMH) severity in stroke patients using volumetric data. The system helps quantify WMH burden and its relationship with various risk factors.

Keywords:
cerebral infarctionleukoaraiosismagnetic resonance imagingtopographic brain mapping

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Area of Science:

  • Neuroimaging
  • Radiology
  • Stroke Research

Background:

  • White matter hyperintensities (WMH) are common in stroke patients.
  • Accurate assessment of WMH severity is crucial for understanding stroke pathology and prognosis.

Purpose of the Study:

  • To develop a graphical and statistical reference dataset for quantifying white matter hyperintensities (WMH) severity in ischemic stroke patients.
  • To establish a novel WMH grading system correlating with patient risk factors.

Main Methods:

  • Prospectively mapped WMHs from 2699 ischemic stroke patients using fluid-attenuated-inversion-recovery (FLAIR) MRIs.
  • Mapped WMHs onto a standard brain template to create topographical frequency-volume maps.
  • Utilized multivariable analyses to assess the impact of risk factors on WMH variability.

Main Results:

  • Generated a reference library of WMH location and quantity as topographical frequency-volume maps.
  • Developed a system for quantitative estimation of WMH severity as a percentile rank score.
  • Identified independent associations of age, hypertension, atrial fibrillation, and left ventricular hypertrophy with increased WMH across different patient subgroups.

Conclusions:

  • Introduced a novel graphical WMH grading system (Kim statistical WMH scoring) adjusted for age and hypertension.
  • The system correlates WMH burden with identified risk factors.
  • Further research is needed to validate the system for individual patient grading and tailored interpretation in clinical practice.