Abstract T P51: MRI Characteristics of the Evolution of Lacunar Infarct Lesions

Abstract

Background and Purpose: Morphological changes of lacunar infarct are not well defined. The purpose of the present study was to describe the MRI characteristics of the evolution of symptomatic lacunar infarcts. Methods: From a prospectively collected stroke database, 62 definite lacunar infarct patients with baseline and follow-up MRI (≥ 90 days of stroke onset) were analyzed. We investigated the incidence of cavitation, the infarct volume change, and the positional relationship between lacunar infarcts and preexisting white matter lesions (WMLs). Results: Median follow-up period was 26 months (range 3-99 months). Cavitation was observed in 38 patients (61%) and 25 lacunar infarct lesions (40%) overlapped with WMLs. Age, hypertension, baseline infarct diameter, baseline infarct volume, and baseline National Institute of Health Stroke (NIHSS) score were associated with cavitation (Figure). In a multiple logistic regression analysis, age (odds ratio per 5-year increase: 1.34; 95% confidence interval (CI): 1.03_1.80; p=0.03) and baseline infarct volume (odds ratio per 1-ml increase: 4.7; 95%CI: 1.6_19.7) were independent predictors of cavitation. There was a significant volume reduction between baseline and follow-up infarct lesions (median volume reduction rate: 44%, p<0.001). Conclusions: More than one third of symptomatic lacunar infarcts developed no cavitation and 40% of lacunar infarct lesions overlapped with WMLs. The incidence of cavitation strongly depended on the patient’s age and baseline infarct volume. Our data indicate the continuity between lacunar infarcts and WMLs.