J Neurosci Methods. 2014 Jan 15;221:196-201. doi: 10.1016/j.jneumeth.2013.10.009.
Accurate and reliable measurement of leukoaraiosis, or MR-detected white, matter hyper-intensity (WMH) burden in subjects with acute ischemic stroke (AIS) is important for, ongoing research studies and future models of risk and outcome prediction, but the presence of a, cerebral infarct may complicate measurement. We sought to assess accuracy of a volumetric method, designed to measure WMH in AIS subjects as compared to the previously validated protocol.
We randomly selected and equally sampled 120 brain scans from the Atherosclerosis, Risk in Communities (ARIC) MRI Study individuals within designated mild, moderate, and severe, tertiles of WMH volume (WMHV). T2 FLAIR axial images were analyzed using the AIS WMH volumetric, protocol and compared with the ARIC (gold standard) method. Pearson correlation coefficients, linear, concordance correlation coefficient, and Blant–Altman procedures were used to assess measurement, agreements between the two procedures.
Median WMHV determined by using the ARIC method was 7.8 cm3 (IQR 5.7–13.55) vs. 3.54 cm3, (IQR 2.1–7.2) using the AIS WMH method. There was good correlation between the two measurements, (r = 0.52, 0.67, and 0.9 for tertiles 1, 2, and 3 respectively) (p < 0.001).
The AIS WMH protocol was specific for leukoaraiosis in ischemic, stroke, but it appeared to underestimate WMHV compared to the gold standard method.
Estimates of MR-detectable WMH burden using a volumetric protocol designed for, analysis of clinical scans correlate strongly with gold standard measurements. These findings will, facilitate future studies of WMH in normal aging and in patients with stroke and other cerebrovascular, disease.
在急性缺血性脑卒中（AIS）患者中，准确可靠地测量脑白质疏松症或磁共振检测到的脑白质高信号（WMH）负担对于正在进行的研究和未来的风险及预后预测模型非常重要，但脑梗死的存在可能会使测量变得复杂。我们旨在评估一种旨在测量 AIS 患者 WMH 的容积法与之前验证的方案相比的准确性。
我们从指定的 WMH 体积（WMHV）轻度、中度和重度三分位的 Atherosclerosis, Risk in Communities (ARIC) MRI 研究个体中随机选择并均等采样了 120 个脑扫描。使用 AIS WMH 容积方案分析 T2 FLAIR 轴位图像，并与 ARIC（金标准）方法进行比较。使用 Pearson 相关系数、线性、一致性相关系数和 Bland–Altman 程序评估两种方法之间的测量一致性。
使用 ARIC 方法确定的 WMHV 中位数为 7.8 cm3（IQR 5.7-13.55），而使用 AIS WMH 方法为 3.54 cm3（IQR 2.1-7.2）。两种测量方法之间具有良好的相关性（分别为 tertiles 1、2 和 3 的 r = 0.52、0.67 和 0.9）（p < 0.001）。
AIS WMH 方案专门用于缺血性脑卒中的脑白质疏松症，但与金标准方法相比，它似乎低估了 WMHV。
为分析临床扫描而设计的容积方案对磁共振可检测的 WMH 负担的估计与金标准测量值密切相关。这些发现将有助于未来在正常衰老以及在患有中风和其他脑血管疾病的患者中对 WMH 的研究。
