WHITE-MATTER HIGH-SIGNAL AREAS ON MRI ASSOCIATED WITH CHRONIC HYPOXIA

Neuroradiological alterations in patients with chronic hypoxia is an a rea yet to be explored. The purpose of our study was to evaluate the p ossibility of changes in cerebral magnetic resonance imaging (MRT) sec ondary to chronic hypoxia. Using healthy persons as control subjects, we studied the MRI findings associated with chronic pulmonary disease, The presence of high-signal areas in cerebral white matter was invest igated in patients with hypoxia due to chronic stable pulmonary diseas e (41 obstructive, three restrictive and six with a mixed pattern) and in 50 control subjects, We recorded the gasometric (Pa-O2 Pa-CO2; pH and CO3H) and spirometric parameters (forced vital capacity [FVC], for ced expiratory volume in 1/s [FEV(1)], and analytical data for erythro cytes, platelets, hemoglobin and hematocrit in the patients and the va scular risk factors in patients and controls, The findings of the MRI were classified into five groups according to the number and extension of the lesions (0, no lesions; I, isolated spotted lesions; II, more than 10 spotted lesions; III, partially confluent lesions; and IV, bil ateral confluent lesions), Vascular risk factors other than respirator y disease were detected in 42% of the patients and 48% of the controls (p < 0.05), Patients with chronic hypoxia showed a higher number and extension of high-signal areas in cerebral white matter (94% in patien ts as compared to 38% in the control group, p < 0.001), The presence o f this lesions on MRI was related only to age (OR 1.2; 95% confidence interval, 1.17-1.41; p = 0.008) and intensity of hypoxia (OR-0.08; 95% confidence interval, 0.026 0.086; p = 0.031), but was independent of the duration of illness, hypercapnia and hematocrit. In conclusion, th e association between chronic pulmonary disease and the occurrence of high-signal areas on the MRI in white matter was demonstrated in our p atients.