What question did this study set out to answer?

To determine the prevalence, anatomical distribution, and associations of DWI-positive lesions with baseline clinical-radiologic features and 6-month functional outcomes in acute intracerebral hemorrhage.

August 16, 2026Neurology0 citationsOpen Access

DWI-Positive Lesions in Patients With Acute Intracerebral Hemorrhage

MLMartina LocatelliQueen Mary University of London HÖHatice ÖzkanUniversity College London Hospitals NHS Foundation Trust GAGiulia AvolaUniversity of Parma

Key Points

To determine the prevalence, anatomical distribution, and associations of DWI-positive lesions with baseline clinical-radiologic features and 6-month functional outcomes in acute intracerebral hemorrhage.
Analyzed consecutive patients with acute intracerebral hemorrhage enrolled in the Stroke Investigation Group in North and Central London registry.
Evaluated acute MRI scans for DWI-positive lesions and cerebral small vessel disease markers according to STandards for ReportIng Vascular changes on nEuroimaging criteria.
Performed adjusted multivariable logistic regression to determine associations with baseline features and poor 6-month functional outcome defined as modified Rankin Scale score ≥3.
DWI-positive lesions were independently associated with severe white matter hyperintensities (OR 3.37, 95% CI 2.72–6.89) and cerebral microbleeds (OR 1.61, 95% CI 1.21–2.93).
DWI-positive lesions were independently associated with intracerebral hemorrhage volume ≥30 mL (OR 2.29, 95% CI 1.76–3.42).
Presence of DWI-positive lesions independently predicted poor 6-month functional outcome (OR 2.16, 95% CI 1.67–3.48).

Abstract

BACKGROUND AND OBJECTIVES: Diffusion-weighted imaging (DWI)-positive lesions are increasingly recognized as markers of cerebral small vessel disease (cSVD) in acute intracerebral hemorrhage (ICH), but their underlying mechanisms, clinical-radiologic associations, and prognostic significance remain uncertain. We therefore aimed to determine their prevalence, anatomical distribution, and associations with baseline clinical-radiologic features and 6-month functional outcome assessed by the modified Rankin Scale (mRS). METHODS: In this prospective cohort study, we analyzed consecutive patients with ICH included in the Stroke Investigation Group in North and Central London registry. We assessed the presence and anatomical distribution of DWI-positive lesions on acute MRI, as well as other cSVD markers rated according to the STandards for ReportIng Vascular changes on nEuroimaging criteria. The primary outcome was disability at 6 months assessed using the mRS. We investigated associations between DWI-positive lesions, clinical-radiologic features, and poor 6-month functional outcome (mRS ≥3) using adjusted multivariable logistic regression. RESULTS: = 0.0006). In adjusted analyses, DWI-positive lesions were independently associated with severe WMH (odds ratio OR 3.37, 95% CI 2.72-6.89), ICH volume ≥30 mL (OR 2.29, 95% CI 1.76-3.42), CMBs (OR 1.61, 95% CI 1.21-2.93), and poor functional outcome at 6 months (OR 2.16, 95% CI 1.67-3.48). DISCUSSION: DWI-positive lesions are common after acute ICH and are independently associated with cSVD and poor functional outcome, supporting their role as a prognostic biomarker. Their anatomical distribution differs according to the underlying cSVD subtype.

AI에게 질문

Bookmark

View Full Paper