경두개 도플러초음파 박동성지수와 대뇌백질 고강도신호 병변과의 관련성

Abstract

Background: The Effect of Cilostazol in Acute Lacunar Infarction Based on Pulsatility Index of the Transcranial Doppler (ECLIPse) study showed a significant decrease in the transcranial Doppler (TCD) pulsatility index (PI) with cilostazol treatment at 90 days after acute lacunar infarction. The aim of the present study was to perform a subgroup analysis of the ECLIPse study in order to explore the relationship between TCD PI and cerebral white matter hyperintensities (WMH) volume in acute lacunar infarction.

Methods: For this subgroup analysis, WMH volume was measured for those subjects for whom fluid-attenuated inversion recovery (FLAIR) images were available using semi-automated computerized software.

Results: Of the 203 patients in eight hospitals in the ECLIPse study, 130 participants from six hospitals were included in this subgroup analysis. The mean WMH volume was 11.57 cm3 (0.13 to 68.45, median 4.86) and the mean MCA PI was 0.95 (0.62 to 1.50). The WMH volume was strongly correlated with age (r=0.388, p<0.001) and mMCA PI (r=0.178, p=0.043). Multiple linear regression analysis revealed that age (p<0.001, β coefficient=0.384) was significantly associated with WMH volume.

Conclusions: Though multiple linear regression analysis revealed that only age was significantly associated with WMH volume, our findings indicate that TCD PIs are elevated when small vessel disease (SVD) is present. These parameters may be a useful physiologic index of the presence and severity of SVD. Further clinical trials focusing on WMH volume and clinical outcomes are required to assess the TCD as a screening tool for SVD.