Diffusion magnetic resonance imaging in cerebral small vessel disease

Area of Science:

• Neurology
• Radiology
• Neuroimaging

Background:

• Cerebral small vessel disease (SVD) is common in older adults, presenting diverse clinical and radiological features.
• Diffusion MRI (DWI) is a key neuroimaging technique for evaluating SVD.

Purpose of the Study:

• To summarize critical findings from diffusion MRI (DWI) in cerebral small vessel disease (SVD).
• To highlight DWI's role in detecting acute lesions and microstructural changes in SVD.

Main Methods:

• Utilizing diffusion MRI (DWI) and apparent diffusion coefficient (ADC) maps.
• Analyzing microstructural changes, including diffusivity and anisotropy, primarily in white matter.

Main Results:

• DWI effectively detects recent ischemic lesions, including multiple simultaneous ones, in SVD patients.
• Increased diffusivity and decreased anisotropy are reliable indicators of microstructural changes in SVD white matter.
• These microstructural changes correlate with clinical severity, particularly executive dysfunction.
• DWI findings can appear before conventional SVD markers like white matter hyperintensities, microbleeds, and lacunes.

Conclusions:

• Diffusion MRI (DWI) offers valuable insights into the mechanisms and progression of cerebral small vessel disease (SVD).
• DWI can serve as an early surrogate marker for SVD progression, aiding in understanding disease pathogenesis.