Relationship between High White Matter Signal and Collateral Circulation in Patients with Ischemic Cerebrovascular Disease
Objective To investigate the correlation between white matter hyperintensities and collateral circulation in patients with ischemic cerebrovascular disease.Methods According to the ASITN/SIR,108 patients with ischemic cerebrovascular disease treated in the Department of Neurology of our hospital from October 2020 to March 2022 were divided into good collateral circulation group and poor collateral circulation group.Comparison of clinical data of two groups of patients,Multivariate Logistic regression analysis affected the independent correlation between white matter hypersignal and collateral circulation in patients with ischemic cerebrovascular disease.Based on this,a Bayesian network model was constructed,and Netica software was used for Bayesian network inference,and the model performance was evaluated.Results Among the 108 patients,58 patients with WMH1,32 patients with WMH2 and 18 patients with WMH3 were found respectively,and the number of patients with WMH1 was more in deep/subcortical distribution.The number of patients with WMH2 and 3 was basically the same in different parts.Among the 108 patients,61 patients with single vessel stenosis(56.48％),47 patients with multiple vessel stenosis(43.52％),51 patients with vascular stenosis＞85％(47.22％),57 patients with＜85％(52.78％),and 50 patients with Willis ring collateral circulation compensation(46.30％),31 cases(28.70％)were compensated by cortical branches,9 cases(8.33％)by neovascularization,and 18 cases(16.67％)without any collateral branches;there were significant differences in smoking history,baseline NIHSS score,hypertension,baseline NIHSS score classification,diabetes,Fazekas total score,Fazekas total score 0～1,periventricular Fazekas score 0～1,deep white matter Fazekas score 0～1,the number of stenotic vessels,the degree of vascular stenosis,and Hcy in patients with collateral circulation disorder(P＜0.05);Multivariate Logistic regression analysis showed that smoking history,hypertension,diabetes,the number of vascular stenosis,the degree of vascular stenosis,Hcy,Fazekas total score and periventricular Fazekas score were the key factors for poor collateral circulation in ICVD patients(P＜0.05);Logistic regression showed that the adjusted WMH score(OR=2.41,95％CI:2.18～2.72,P＜0.001)remained a risk factor for poor collateral circulation establishment in ICVD patients.With the increase of WMH score,its associated effect size also increased(Ptrend＜0.05).The accuracy rate was 88.9％and the AUC of the constructed Bayesian network model was 0.807(95％CI:0.781～0.874),which had a high degree of discrimination.Conclusion The establishment of collateral circulation in patients with ischemic cerebrovascular disease is affected by many factors,the severity of high white matter signal is related to poor collateral circulation in patients with ischemic cerebrovascular disease.The severity of WMH can be used to evaluate the establishment of collateral circulation in ICVD patients in clinical practice,in order to provide further reference for the evaluation of neurological deficits in patients.
White Matter Hyperintensity(WMH)Ischemic Cerebrovascular DiseaseCollateral CirculationCorrelation
万方数据
维普
