Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
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Updated: Mar 29, 2026
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Susanne J van Veluw1, Geert Jan Biessels2, Peter R Luijten3
1Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht; S.J.Veluw-2@umcutrecht.nl.
Abstract:
Cerebral microinfarcts are frequent findings in the post-mortem human brain, and are related to cognitive decline and dementia. Due to their small sizes it is challenging to study them on clinical MRI scans. It was recently demonstrated that cortical microinfarcts can be depicted with MRI scanners using high magnetic field strengths (7T). Based on this experience, a proportion of these lesions is also visible on lower resolution 3T MRI. These findings were corroborated with ex vivo imaging of post-mortem human brain tissue, accompanied by histopathological verification of possible cortical microinfarcts. Here an ex vivo imaging protocol is presented, for the purpose of validating MR observed cerebral microvascular pathology with histological evaluation. Furthermore, guidelines are provided for the assessment of cortical microinfarcts on both in vivo 7T and 3T MR images. These guidelines provide researchers with a tool to rate cortical microinfarcts on in vivo images of larger patient samples, to further unravel their clinical relevance in cognitive decline and dementia, and establish these lesions as a novel biomarker of cerebral small vessel disease.
Insights
Cortical microinfarcts, linked to dementia, are now visible on 7T and 3T MRI scans. This study offers guidelines for assessing these microinfarcts as a potential biomarker for cognitive decline.
Area of Science:
- Neuroimaging
- Neuropathology
- Vascular Neurology
Background:
- Cerebral microinfarcts are common in post-mortem brains and associated with cognitive decline.
- Their small size poses challenges for detection using standard clinical MRI.
- High-field (7T) MRI has shown promise in visualizing cortical microinfarcts.
Purpose of the Study:
- To present an ex vivo imaging protocol for validating MR-observed microinfarcts with histology.
- To provide guidelines for assessing cortical microinfarcts on in vivo 7T and 3T MRI.
- To facilitate further research into the clinical relevance of microinfarcts in cognitive decline and dementia.
Main Methods:
- Ex vivo imaging of post-mortem human brain tissue.
- Histopathological verification of microinfarcts.
- Development of assessment guidelines for in vivo 7T and 3T MRI.
Main Results:
- Cortical microinfarcts are visible on both 7T and 3T MRI.
- Ex vivo imaging and histology confirm MR findings.
- Guidelines for in vivo assessment were established.
Conclusions:
- MRI, particularly at 7T and 3T, can depict cortical microinfarcts.
- The developed protocol and guidelines enable validation and assessment of these lesions.
- Cortical microinfarcts may serve as a novel biomarker for cerebral small vessel disease and cognitive decline.
