Link between Linear Hyperintensity Objects in Cerebral White Matter and Hypertensive Intracerebral Hemorrhage

Abstract

Background: We retrospectively studied the relationship between linear hyperintensity objects (LHOs) on T₂-weighted magnetic resonance images (MRI) in the cerebral white matter and the occurrence of hypertensive intracerebral hemorrhage (HIH). Methods: Forty-nine hypertensive patients with a fixed imaging condition MRI were classified into three groups: HIH (n = 17), ischemic stroke due to hypertensive vasculopathy (n = 19), and hypertension only (n = 13). After assessing clinical and radiological background information among these groups and the reliability of LHO measurements, polynomial logistic regression analysis was used to identify the factors relating to HIH. Results: HIH had a significantly higher LHO number (p = 0.002) and larger diameter (p = 0.007). The LHO number showed an excellent interrater (ĸ = 0.91, 95% CI = 0.87–0.94, SEM = 6.2%) and intrarater reliability (ĸ = 0.95, 95% CI= 0.92–0.97, SEM = 4.8%), and was the most significant independent indicator of HIH (OR = 1.29, 95% CI = 1.05–1.60, p = 0.017). The number of microbleeds was an additional indicator (OR = 3.73, 95% CI = 1.10–12.65, p = 0.034). Conclusions: LHOs are closely linked to HIH. A prospective, longitudinal study is needed to clarify whether LHOs can predict HIH.