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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
The spectrum of MR detectable cortical microinfarcts: a classification study with 7-tesla postmortem MRI and
Susanne J van Veluw1, Jaco J M Zwanenburg2, Annemieke Jm Rozemuller3
1Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Abstract:
Cerebral microinfarcts (CMIs) are common neuropathologic findings in aging and dementia. We explored the spectrum of cortical CMIs that can be visualized with 7 T magnetic resonance imaging (MRI). Thirty-three coronal brain slices of 11 individuals with neuropathologically confirmed dementia were subjected to a high-resolution postmortem 7 T MRI protocol. First, we identified all visible small (⩽ 5 mm) intracortical and juxtacortical lesions on postmortem MRI. Lesions were classified as CMI or nonCMI based on histology, and their MR features were recorded. Thirty lesions were identified on the initial MRI evaluation, of which twenty-three could be matched with histology. Histopathology classified 12 lesions as CMIs, all of which were located intracortically. On the basis of their MR features, they could be classified as chronic gliotic CMIs--with or without cavitation or hemorrhagic components--and acute CMIs. Eleven MRI identified lesions were not of ischemic nature and most commonly enlarged or atypically shaped perivascular spaces. Their MRI features were similar to gliotic CMIs with or without cavitation, but these 'CMI mimics' were always located juxtacortically. 7 T postmortem MRI distinguishes different histopathologic types of cortical CMIs, with distinctive MR characteristics. On the basis of our findings, we propose in vivo rating criteria for the detection of intracortical CMIs.
Insights
High-resolution 7 T MRI can distinguish between cerebral microinfarcts (CMIs) and mimics. This study proposes new criteria for detecting intracortical CMIs in vivo.
Area of Science:
- Neuroimaging
- Neuropathology
- Gerontology
Background:
- Cerebral microinfarcts (CMIs) are prevalent in aging and dementia.
- Accurate identification of CMIs is crucial for understanding neurodegenerative diseases.
Purpose of the Study:
- To explore the spectrum of cortical CMIs visualized by 7 Tesla (7 T) MRI.
- To develop in vivo rating criteria for detecting intracortical CMIs.
Main Methods:
- High-resolution postmortem 7 T MRI was performed on 33 brain slices from 11 individuals with dementia.
- Lesions were identified, classified as CMI or non-CMI via histology, and their MR features recorded.
- Distinction was made between intracortical CMIs and juxtacortical 'CMI mimics' like enlarged perivascular spaces.
Main Results:
- Histology confirmed 12 CMIs, all intracortical, with distinct MR features for chronic (gliotic, cavitated, hemorrhagic) and acute types.
- Eleven non-ischemic lesions, primarily enlarged perivascular spaces, mimicked CMIs on MRI but were juxtacortical.
- 7 T MRI successfully differentiated histopathologic CMI types and mimics based on distinct MR characteristics.
Conclusions:
- Postmortem 7 T MRI can reliably distinguish histopathologic subtypes of cortical CMIs.
- Distinct MR features aid in differentiating CMIs from mimics like enlarged perivascular spaces.
- Proposed in vivo rating criteria may improve intracortical CMI detection.
