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Longitudinal In Vivo Imaging of the Cerebrovasculature: Relevance to CNS Diseases
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Evolution of DWI lesions in cerebral amyloid angiopathy: Evidence for ischemia

Susanne J van Veluw1, Arne Lauer2, Andreas Charidimou2

  • 1From the Hemorrhagic Stroke Research Program, Department of Neurology (S.J.v.V., A.L., A.C., N.B., L.X., G.B., P.F., A.A., M.E.G., A.V., S.M.G., M.W.V.), Massachusetts General Hospital, Harvard Medical School, Boston; and Departments of Radiology and Nuclear Medicine (M.W.V.) and Epidemiology (M.W.V.), Erasmus MC, Rotterdam, the Netherlands. svanveluw@mgh.harvard.edu.

Neurology
|October 27, 2017
PubMed
Abstract

Insights

Diffusion-weighted imaging (DWI) lesions in cerebral amyloid angiopathy (CAA) appear ischemic and are linked to chronic cortical cerebral microinfarcts (CMIs). These DWI lesions represent a component of the CMI spectrum in CAA patients.

Area of Science:

  • Neurology
  • Radiology
  • Neuroimaging

Background:

  • Cerebral amyloid angiopathy (CAA) is a common neurodegenerative disease.
  • Small diffusion-weighted imaging (DWI) lesions are frequently observed in CAA patients.
  • The exact pathophysiologic nature of these DWI lesions remains unclear.

Purpose of the Study:

  • To investigate the nature of small diffusion-weighted imaging (DWI) lesions in patients with cerebral amyloid angiopathy (CAA).
  • To determine if DWI lesions preferentially occur in patients with prior DWI lesions.
  • To assess the association of DWI lesions with chronic cortical cerebral microinfarcts (CMIs) and their evolution over time.

Main Methods:

  • Serial MRI scans were analyzed in 79 patients with probable CAA.
  • Diffusion-weighted imaging (DWI) lesions were identified and characterized.
  • Association with other neuroimaging markers of small vessel disease, including chronic cortical CMIs, was assessed.

Main Results:

  • Sixty DWI lesions were identified in 28 patients.
  • Patients with baseline DWI lesions were not more likely to develop new lesions.
  • DWI lesions were associated with chronic cortical CMIs and cortical superficial siderosis.

Conclusions:

  • Diffusion-weighted imaging (DWI) lesions in CAA likely have an ischemic origin.
  • These lesions are associated with chronic cortical cerebral microinfarcts (CMIs).
  • DWI lesions are considered part of the CMI spectrum in CAA.

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