Population-Based Prevalence of Infarctions on 3D Fluid-Attenuated Inversion Recovery (FLAIR) Imaging

Overview

Journal J Stroke Cerebrovasc Dis

Specialties Cardiology & Vascular Diseases
Neurology

Date 2022 Jun 11

PMID 35689933

Authors

Petrice M Cogswell

Jeremiah A Aakre

Anna M Castillo

David S Knopman

Kejal Kantarci

Alejandro A Rabinstein

Ronald C Petersen

Clifford R Jack Jr

Michelle M Mielke

Prashanthi Vemuri

Jonathan Graff-Radford

Affiliations

Soon will be listed here.

Abstract

Objectives: To report population-based, age-specific prevalence of infarctions as identified via 3D fluid-attenuated inversion recovery (FLAIR) imaging.

Materials And Methods: Participants without dementia in the Mayo Clinic Study of Aging (MCSA), a population-based study in Olmsted County, MN, age 50-89 who underwent 3D FLAIR imaging between 2017 and 2020 were included. Infarctions per participant were determined via visual interpretation. Inter- and intra-reader reliability were calculated. Infarction prevalence on 3D FLAIR was derived by standardization to the Olmsted County population and was compared to that previously reported on 2D FLAIR imaging.

Results: Among 580 participants (mean age 71 years, 46% female) the prevalence (95% confidence interval) of any infarction was 5.0% (0.0%-9.9%) at age 50-59 years and 38.8% (28.6%-49.0%) at 80-89 years. In addition to increasing with age, the prevalence varied by sex and type of infarction. Prevalence estimates of cortical infarcts were 0.9% (0.0%-2.7%) at age 50-59 years and 20.2% (10.7%-29.7%) at 80-89 years and lacunar infarcts 4.1% (0.0%-8.8%) at age 50-59 years and 31.2% (21.5%-41.0%) at 80-89 years. Prevalence estimates of any infarction by sex were: men, 8.7% (0.0%-18.7%) at 50-59 years and 54.9% (41.0%-68.8%) at 80-89 years and women, 2.4% (0.0%-7.3%) at age 50-59 years and 27.3% (12.9%-41.7%) at 80-89 years. Intra- and inter- reader reliability were very good (kappa = 0.85 and 0.82, respectively). After adjusting for age, sex and education, individuals imaged with 3D FLAIR were 1.5 times (95% CI 1.2-1.8, p<0.001) more likely to be identified as positive for infarction compared to those imaged with 2D FLAIR.

Conclusions: Infarction prevalence increases with age and is greater in men than women. Infarction prevalence on 3D FLAIR imaging, which has become more widely implemented as an alternative to 2D FLAIR over the past several years, will be a useful reference in future work.

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