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Updated: May 22, 2026
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
In vivo detection of cortical microinfarcts on ultrahigh-field MRI
Yuichiro Ii1, Masayuki Maeda, Hirotaka Kida
1Department of Neurology, Mie University Graduate School of Medicine, Mie, Japan. ii-y@clin.medic.mie-u.ac.jp
Background And Purpose:
Cortical microinfarcts (CMIs) are detected as small foci restricted to the cerebral cortex in autopsy brains. CMIs are thought to be caused by cerebral amyloid angiopathy (CAA) in the elderly and may be a risk for dementia. We aimed to visualize CMIs, which remain invisible on conventional MRI, using double inversion recovery (DIR) and 3-dimensional fluid attenuated inversion recovery (3D-FLAIR) on 3-Tesla MRI.
Methods:
We prospectively performed DIR and 3D-FLAIR images in 70 subjects with Alzheimer disease (AD; n = 47), mild cognitive impairment (n = 14), AD with cerebrovascular disease (CVD; n = 3), vascular dementia (VaD; n = 2), CAA-associated intracerebral hemorrhage (ICH; n = 2) and one each of normal pressure hydrocephalus and dementia with Lewy bodies (DLB). Susceptibility-weighted imaging (SWI) was performed to detect cerebral microbleeds (CMBs).
Results:
Nine subjects (five of AD and one each of AD with CVD, ICH, VaD, and DLB) had small intracortical high signal lesions on both DIR and 3D-FLAIR images. All the nine subjects accompanied multiple lobar CMBs. These intracortical lesions were located in close proximity to CMBs, and were suggested to be CMIs.
Conclusions:
DIR and 3D-FLAIR images may open a way to visualize CMIs.
Insights
New MRI techniques, double inversion recovery (DIR) and 3D-FLAIR, show promise for visualizing cortical microinfarcts (CMIs) in the brain. These small lesions, previously undetectable, may be linked to dementia risk.
Area of Science:
- Neuroimaging
- Neuropathology
- Radiology
Background:
- Cortical microinfarcts (CMIs) are small lesions in the cerebral cortex, often associated with cerebral amyloid angiopathy (CAA) and dementia risk.
- CMIs are typically invisible on conventional MRI scans.
- Advanced MRI techniques are needed to detect these subtle pathologies.
Purpose of the Study:
- To evaluate the utility of double inversion recovery (DIR) and 3-dimensional fluid attenuated inversion recovery (3D-FLAIR) MRI sequences for visualizing cortical microinfarcts (CMIs).
- To determine if these advanced MRI techniques can detect CMIs in patients with various neurological conditions.
Main Methods:
- Prospective imaging study involving 70 subjects with conditions including Alzheimer disease (AD), mild cognitive impairment (MCI), and vascular dementia (VaD).
- Acquisition of DIR and 3D-FLAIR MRI sequences on a 3-Tesla scanner.
- Susceptibility-weighted imaging (SWI) was used to detect cerebral microbleeds (CMBs).
Main Results:
- Nine subjects (12.8%) exhibited small, intracortical high-signal lesions on both DIR and 3D-FLAIR images.
- These lesions were consistently associated with multiple lobar cerebral microbleeds (CMBs) detected on SWI.
- The identified lesions were located near CMBs, suggesting they represent cortical microinfarcts (CMIs).
Conclusions:
- Double inversion recovery (DIR) and 3D-FLAIR MRI sequences show potential for visualizing cortical microinfarcts (CMIs).
- These advanced imaging methods may improve the detection and understanding of CMIs and their role in neurological diseases.
