Incidence and Risk Factors of Occasional Diffusion-Weighted Imaging-Positive Lesions in Patients with Recent Small Subcortical Infarcts
Abstract：Objective: Patients with recent small subcortical infarcts (RSSI) who have cerebral small vessel disease (CSVD) may present with incidental diffusion-weighted imaging (DWI)-positive lesions outside the responsible lesion. This study aimed to analyze the incidence and risk factors of incidental DWI-positive lesions in RSSI patients. Methods: A retrospective analysis was conducted on 240 RSSI patients hospitalized in the Department of Neurology at Zhongguancun Hospital, Beijing, from September 2019 to October 2024. Patients were divided into two groups based on the presence of incidental DWI-positive lesions: the DWI-positive group (39 cases) and the DWI-negative group (201 cases). Clinical and imaging differences between the two groups were compared. Results: Compared with the DWI-negative group, the DWI-positive group showed significantly lower scores on the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), and higher scores on periventricular white matter hyperintensities, deep white matter hyperintensities, lacunes, cerebral microbleeds, and total CSVD burden score (P < 0.05, P < 0.01). Binary logistic regression analysis showed that the total CSVD burden score was an independent risk factor for the occurrence of incidental DWI-positive lesions (OR = 2.275, 95% CI: 1.106–4.680, P = 0.025). Conclusion: RSSI patients with a heavier CSVD burden are more likely to develop incidental DWI-positive lesions.
Keywords：Cerebral small vessel diseaseRisk factorsNeuroglial lymphatic systemRecent small subcortical infarctsIncidental diffusion-weighted imaging-positive lesions
Publication Date：2025-05-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 656-658 )