White matter hyperintensities regress at a high rate at three months after minor ischemic stroke or transient ischemic attack

Yuyun Xu; Danjiang Huang; He Zhang; Qifen Fang; Yuwei Xia; Feng Shi; Xiangyang Gong

doi:10.1016/j.neurad.2024.101239

White matter hyperintensities regress at a high rate at three months after minor ischemic stroke or transient ischemic attack

J Neuroradiol. 2025 Jan 9;52(1):101239. doi: 10.1016/j.neurad.2024.101239. Online ahead of print.

Authors

Yuyun Xu¹, Danjiang Huang², He Zhang², Qifen Fang³, Yuwei Xia⁴, Feng Shi⁴, Xiangyang Gong⁵

Affiliations

¹ Soochow Medical college of Soochow University, Suzhou, PR China; Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, PR China.
² Taizhou First People's Hospital, Huangyan Hospital of Wenzhou Medical College, PR China.
³ Hangzhou Normal University, PR China.
⁴ Shanghai United Imaging Intelligence, Shanghai, PR China.
⁵ Soochow Medical college of Soochow University, Suzhou, PR China; Center for Rehabilitation Medicine, Department of Radiology, Zhejiang Provincial People's Hospital (Affiliated People's Hospital, Hangzhou Medical College), Hangzhou, Zhejiang, PR China. Electronic address: cjr.gxy@hotmail.com.

PMID: 39798248
DOI: 10.1016/j.neurad.2024.101239

Abstract

Background: The potential for early white matter hyperintensities(WMH) regression and associated contributory factors remains uncertain. The purpose of this study is to investigate whether WMH regress at early time of three months after minor ischemic stroke (MIS) or transient ischemic attack (TIA), while also identifying factors that may influence this outcome.

Methods: A retrospective analysis of a prospective subcohort from the CHANCE trial comprising individuals with MIS and TIA was conducted. All patients underwent brain MRI at the onset and at three months. Deep learning algorithms were employed for the automatic segmentation of WMH volumes in four distinct regions. Scores for lacunes, cerebral microbleeds (CMB), perivascular spaces (PVS), WMH, and overall cerebral small vessel disease (CSVD) burden were quantified. Patients were divided into the stable, regression and progression groups according to change in WMH volume. The demographic, clinical, and imaging data of the participants in the three groups were collected and statistically analyzed.

Results: A total of 98 patients with minor ischemic stroke or TIA were included. There were 22 patients in the stable group, 41 patients in the regression group and 35 patients in the progression group. Age and hypertension status were significantly different among the three groups. The lacunes, CMB,WMH, and total CSVD burden scores differed notably among groups, with all the CSVD markers being severely elevated in the progression group, moderately elevated in the regression group, and subtly elevated in the stable group.

Conclusion: The findings suggest that WMH could exhibit regression within three months following minor ischemic stroke or TIA. Patients under the age of 65, without a hypertension history, and with a low CSVD burden are more likely to experience WMH regression.

Keywords: Cerebral small vessel disease; Deep learning; Magnetic resonance imaging; Stroke; Transient ischemic attack; White matter hyperintensities.