Microstructural Characteristics of White Matter in Patients with Acute Ischemic Stroke and Their Relationship with Collateral Circulation
10.3870/j.issn.1672-0741.24.07.023
- VernacularTitle:急性缺血性脑卒中患者脑白质微观结构特征及其与侧支循环的关系
- Author:
Yongyi ZHANG
1
;
Rong FU
;
Juan LIU
Author Information
1. 贵阳市第四人民医院神经内科,贵阳 550007
- Publication Type:Journal Article
- Keywords:
ischemic stroke;
white matter;
microscopic structure;
collateral circulation;
scattering tensor imaging
- From:
Acta Medicinae Universitatis Scientiae et Technologiae Huazhong
2025;54(4):523-534
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore the microstructural characteristics of white matter in patients with acute ischemic stroke and their relationship with collateral circulation.Methods In all,150 patients with acute ischemic stroke admitted to our hospi-tal from January 2023 to May 2024 were selected as the study subjects,and another 150 healthy volunteers during the same peri-od were selected as the control group to compare the general clinical data of the two groups.All subjects underwent head MRI examination to extract microstructural features of brain white matter and analyze the correlation between microstructural fea-tures of brain white matter and brain white matter lesions.According to the formation status of collateral circulation,150 pa-tients with acuteischemic stroke were divided into good collateralcirculation group(n=91)and poor collateral circulation group(n=59).The general clinical data and microstructure characteristics of white matter were compared between the two groups.The predictive value of microstructurecharacteristics of white matter for stroke,white matter lesions,and poor collater-al circulation were analyzed using ROC curves.Results Comparing the general information between the healthy group and the stroke group,it could be seen that there were significant differences between the two groups in terms of smoking history,hyper-lipidemia history,hypertension history,LDL-C,HDL-C,FIB,and D-D(all P<0.05);The brain white matter fiber bundles with statistically significant FA values in the healthy and stroke groups included:cerebellar peduncle,pontine chiasmatic tract,corpus callosum,fornix column and fornix body,right corticospinal tract,left corticospinal tract,right cerebellar peduncle,left cerebellar peduncle,right anterior radial crown,and left anterior radial crown;The brain white matter fiber bundles with statistically sig-nificant MD values in the healthy and stroke groups included:cerebellar peduncle,pontine chiasmatic tract,right cerebellar pe-duncle,left cerebellar peduncle,right external capsule,left external capsule,and right frontal occipital bundle;The brain white matter fiber bundles with statistically significant RD values in the healthy and stroke groups included:cerebellar peduncle,pon-tine chiasmatic tract,left corticospinal tract,right cerebellar peduncle,left cerebellar peduncle,right cerebellar peduncle,left cer-ebellar peduncle,right external capsule,and left external capsule;The brain white matter fiber bundles with statistically signifi-cant AD values in the healthy and stroke groups included:midcerebellar peduncle,right medial thalamus,left medial thalamus,right superior cerebellar peduncle,left superior cerebellar peduncle,right posterior thalamic radiation,right sagittal layer,right external capsule,left external capsule,right cingulate and left cingulate.Correlation analysis showed that the FA values of the cerebellar peduncle,pontine chiasmatic tract,corpus callosum,fornix column and fornix body,right corticospinal tract,left corti-cospinal tract,right cerebellar peduncle,left cerebellar peduncle,right anterior radial crown,and left anterior radial crown were significantly negatively correlated with the white matter lesion score(all P<0.05);The MD values of the cerebellar peduncle,pontine chiasmatic tract,right cerebellar peduncle,left cerebellar peduncle,right external capsule,left external capsule,and right frontal occipital tract were significantly positively correlated with the white matter lesion score(all P<0.05);The RD values of the cerebellar peduncle,pontine chiasmatic tract,left corticospinal tract,right cerebellar peduncle,left cerebellar peduncle,right cerebellar peduncle,left cerebellar peduncle,right external capsule,and left external capsule were significantly positively correla-ted with the white matter lesion score(all P<0.05);The AD values of the cerebellar peduncle,right cerebellar peduncle,left cerebellar peduncle,right external capsule,and left external capsule were significantly positively correlated with the white matter lesion score(all P<0.05),while the AD values of the right medial thalamus,left medial thalamus,right posterior thalamus radi-ation,right sagittal layer,right cingulate and left cingulate were significantly negatively correlated with the white matter lesion score(all P<0.05).Comparing the general information between good collateral circulation group and poor collateral circulation group,it could be seen that there was a significant difference in the white matter lesion score between the two groups of patients(P<0.05).The ROC analysis showed that FA,MD,RD,and AD values in the cerebellar midfoot had good predictive value for stroke,white matter injury,and collateral circulation disorders,and the combined diagnostic efficacy of the four values was high-er than the diagnostic efficacy of each value alone.Conclusion The microstructure of white matter in patients with acute ische-mic stroke exhibits varying degrees of damage.Changes in FA,MD,AD,and RD values in the white matter of the cerebellar pe-duncle can be used to differentiate collateral circulation status,and the combined diagnostic efficacy of the four is better.
