title: Progression of Cerebral White Matter Hyperintensities and the Associated Sonographic Index.
abstract: Purpose To evaluate the relationship between penetrating arterial pulsation and the progression of white matter hyperintensities (WMHs) by using the sonographic resistance index (RI) along the M1 segment of the middle cerebral artery (MCA). Materials and Methods The study design was approved by the institutional review board of Seoul National University Hospital. The study included 450 individuals who had undergone initial transcranial Doppler (TCD) sonography and magnetic resonance imaging, with follow-up imaging performed within 34-45 months, and who had no stenosis of 30% or more in the internal carotid artery or MCA or a history of stroke other than an old lacunar infarction. MRIR was defined as distal RI divided by proximal RI, where the distance between proximal MI and distal M1 was approximately 20 mm based on TCD evaluation. WMH progression was quantitatively evaluated by subtracting WMH volume at baseline from WMH volume at follow-up. Results At baseline, mean MRIR was 0.974 ± 0.045 (standard deviation), and mean WMH volume was 9.66 mL ± 14.54. After a mean of 38.3 months ± 3.4, the WMH volume change was 4.06 mL ± 7.35. WMH volume change was linearly associated with MRIR (r = 0.328, P < .001), along with the baseline WMH volume (r = 0.433, P < .001) and mean MCA pulsatility index (r = 0.275, P = .037). MRIR values greater than or equal to 1.000 were associated with a greater increase in WMH volume (P < .001). Conclusion MRIR might reflect the pulsation of penetrating arteries and is independently associated with WMH progression.©RSNA, 2017 Online supplemental material is available for this article.
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Woo-Jin
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Keun-Hwa
authors.initials: KH
authors.lastname: Jung
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Ryu
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Keon-Joo
authors.initials: KJ
authors.lastname: Lee
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Jeong-Min
authors.initials: JM
authors.lastname: Kim
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Soon-Tae
authors.initials: ST
authors.lastname: Lee
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Kon
authors.initials: K
authors.lastname: Chu
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Manho
authors.initials: M
authors.lastname: Kim
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Sang Kun
authors.initials: SK
authors.lastname: Lee
authors.affiliation: From the Departments of Neurology (W.J.L., K.H.J., K.J.L., S.T.L., K.C., M.K., S.K.L., J.K.R.) and Radiology (Y.J.R.), Seoul National University Hospital, 101 Daehangno, Jongno-gu, Seoul 110-744, South Korea; Program in Neuroscience, Neuroscience Research Institute of SNUMRC, College of Medicine, Seoul National University, Seoul, South Korea (K.H.J., S.T.L., K.C., M.K., S.K.L.); Department of Neurology, Chung-Ang University Hospital, Seoul, South Korea (J.M.K.); and Department of Neurology, the Armed Forces Capital Hospital, Sungnam, South Korea (J.K.R.).
authors.forename: Jae-Kyu
authors.initials: JK
authors.lastname: Roh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging* / Q000473:pathology; D012189:Retrospective Studies; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods* / Q000706:statistics & numerical data; D014655:Vascular Resistance / Q000502:physiology; D066127:White Matter / Q000000981:diagnostic imaging* / Q000473:pathology