The relationship between intracranial artery stenosis and white matter lesions in patients with lacunar infarcts

Objective To investigate the relationship between intracranial artery stenosis and white matter lesions(WML) in patients with lacunar infarcts. Methods From January 2015 to March 2016, clinical data of 279 patients who had the lacunar infarcts in the Neurology Department of Daping Hospital of Third Military Medical University were retrospectively analyzed, including 122 males and 157 females with an average of (66.2±7.9) years. Using MRI to determine the diagnosis of WML and divide into two groups: WML group (164 patients) and without WML group (115 patients). The application of 64 slice spiral CT to assess intracranial vascular. The assessment of intracranial artery stenosis refer to the research methods of symptoms of intracranial artery disease warfarin aspirin(the diagnosis was established if the stenosis rate was more than or equal to 50%). Multivariate logistic regression analyses were performed to examine the association between different intracranial artery stenosis and white matter lesions in patients with lacunar infarcts. Results Among 279 patients with lacunar infarcts in the study. The prevalence of intracranial arterial stenosis 68(24.3%) patients including 51 patients of WML group and 17 patients without WML group. The patients in lacunar infarcts with WML group had a higher average age, and the mobidity of hypertension, diabetes, coronary heart disease, prior stroke, intracranial arterial stenosis was significantly higher compared with those in lacunar cerebral infarction without WML group(all P values<0.05). The incidence of middle cerebral artery stenosis in group WML (16.5% vs 7.0%) was higher (χ2=5.568, P<0.05). After adjustment of age, hypertension, diabetes, coronary heart disease, previous stroke history of these risk factors, logistic regression analysis showed that cerebral artery stenosis with WML risk related in patients with lacunar infarcts(OR=2.13, 95%CI 1.18-3.25, P<0.05 ). Conclusions The middle cerebral artery stenosis may contribute to the risk factors of WML in patients with lacunar infarcts. Key words: Lacunar infarcts; White matter lesions; Middle cerebral artery; Artery stenosis