Clinical characteristics and brain MRI findings in myeloproliferative neoplasms

J Neurol Sci. 2020 Sep 15:416:116990. doi: 10.1016/j.jns.2020.116990. Epub 2020 Jun 19.

Abstract

Background: Myeloproliferative neoplasms (MPNs) including polycythemia vera (PV) and essential thrombocythemia (ET) have an increased risk of ischemic stroke. However, little is known about brain morphological changes and the cerebral vasculature in MPNs. The aim of the present study is to clarify the prevalence rates of brain infarcts (BIs) on magnetic resonance imaging (MRI) and to assess the detailed clinical and MRI characteristics in those patients.

Methods: We prospectively enrolled patients with MPNs who underwent brain MRI between September 2017 and June 2019. BI patterns were characterized by the numbers and locations of BIs on MRI.

Results: A total of 101 patients were included in the present study. BIs were observed in 23 patients (23%). Multiple logistic regression analysis showed that age > 60 years (odds ratio (OR) 7.34, 95% confidence interval (CI) 1.08-49.7, p = .041) and history of thrombosis (OR 40.6, 95% CI 7.97-207, p < .0001) were independently associated with BIs, but not the JAK2V617F mutation. Of the 23 patients with BIs, eight patients (35%) had multiple territorial infarcts, and large vessel involvement was identified in five patients (22%). Two patients had thrombus formation in large vessels.

Conclusions: Among patients with MPNs who underwent MRI, BIs were observed in 23% of patients followed up in our center. Older age and thrombosis history were independently associated with BIs. Some patients with MPNs may present with distinctive MRI findings including multiple territorial infarcts and thrombus formation in large vessels.

Keywords: Arterial thrombosis; JAK2V617F; Magnetic resonance imaging; Myeloproliferative neoplasms; Neuroimage; Neurosonology; Risk factors; Stroke.

MeSH terms

  • Aged
  • Brain / diagnostic imaging
  • Humans
  • Janus Kinase 2 / genetics
  • Magnetic Resonance Imaging
  • Middle Aged
  • Mutation
  • Myeloproliferative Disorders* / diagnostic imaging
  • Myeloproliferative Disorders* / epidemiology
  • Polycythemia Vera* / complications
  • Polycythemia Vera* / diagnostic imaging
  • Polycythemia Vera* / genetics
  • Thrombocythemia, Essential* / complications
  • Thrombocythemia, Essential* / diagnostic imaging
  • Thrombocythemia, Essential* / genetics

Substances

  • Janus Kinase 2