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Portable MRI accurately measures white matter hyperintensities (WMH), a risk factor for stroke. A new risk score using age, blood pressure, atrial fibrillation, and tobacco use effectively identifies patients needing WMH screening.

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Area of Science:

  • Neurology
  • Medical Imaging
  • Public Health

Background:

  • White matter hyperintensities (WMH) are linked to stroke and dementia.
  • Portable MRI (pMRI) offers a cost-effective method for WMH detection.
  • Accurate WMH measurement is crucial for risk stratification and patient management.

Purpose of the Study:

  • To validate pMRI for accurate WMH measurements.
  • To develop and validate a predictive risk model for WMH on pMRI.
  • To identify patients who could benefit from pMRI screening for WMH.

Main Methods:

  • Two cohorts (N=143 development, N=127 validation) of patients without acute neurologic pathology underwent pMRI.
  • Conventional MRIs (cMRIs) were used for validation in the validation cohort.
  • A WMH segmentation software processed T2-FLAIR sequences from pMRI for quantification.

Main Results:

  • A risk model including age, SBP >140, atrial fibrillation, and tobacco use achieved an AUC of 0.83-0.85.
  • WMH measurements from pMRI showed strong agreement with cMRI (r=0.93, p<0.001).
  • The model demonstrated reproducible performance across development and validation cohorts.

Conclusions:

  • The developed WMH risk score accurately identifies patients with significant WMH burden.
  • pMRI shows promise as a screening tool for WMH.
  • Targeted pMRI screening can aid in proactive management of vascular risk factors and improved neurological outcomes.