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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images

Published on: November 20, 2015

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Cortical microinfarcts in patients with multiple lobar microbleeds on 3 T MRI

Yuichiro Ii1, Masayuki Maeda2, Hidehiro Ishikawa3

  • 1Department of Neurology, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-8507, Japan. ii-y@clin.medic.mie-u.ac.jp.

Journal of Neurology
|May 4, 2019
PubMed

Insights

Cortical microinfarcts (CMIs) in advanced cerebral small vessel disease (SVD) differ based on underlying causes. Probable cerebral amyloid angiopathy (CAA) is linked to cortical superficial siderosis, while mixed SVD suggests advanced hypertensive vasculopathy (HV).

Area of Science:

  • Neurology
  • Neuroimaging
  • Cerebrovascular Diseases

Background:

  • Cortical microinfarcts (CMIs) pathogenesis is heterogeneous, involving cerebral small vessel disease (SVD) subtypes like hypertensive vasculopathy (HV) and cerebral amyloid angiopathy (CAA).
  • Advances in MRI allow in vivo detection of CMIs, crucial for understanding their role in cognitive impairment associated with SVD.

Purpose of the Study:

  • To investigate the characteristics of CMIs in patients with advanced SVD and cognitive impairment.
  • To differentiate the underlying SVD pathologies associated with CMIs based on MRI findings, specifically cerebral microbleeds (CMBs) patterns.

Main Methods:

  • Retrospective analysis of 85 patients with cognitive impairment and multiple lobar CMBs on 3T MRI.
  • Classification into probable-CAA (strictly lobar CMBs) and mix-CMBs (non-lobar with lobar CMBs) groups.
  • Evaluation of relationships between CMIs, CMBs, cortical superficial siderosis (cSS), and white matter hyperintensity.

Main Results:

  • CMIs were present in 22.0% of the probable-CAA group (19 CMIs) and 27.3% of the mix-CMBs group (38 CMIs).
  • In the probable-CAA group, CMIs significantly correlated with cSS (p < 0.001), showing close spatial association.
  • In the mix-CMBs group, CMIs significantly correlated with the number of frontal lobe lobar CMBs (p = 0.034).

Conclusions:

  • CMIs in probable-CAA patients may indicate more severe CAA pathology.
  • CMIs in the mix-CMBs group suggest advanced HV, particularly when associated with numerous lobar CMBs.
  • MRI findings differentiate potential underlying SVD pathologies contributing to CMIs and cognitive impairment.
Keywords:
Cerebral amyloid angiopathyCerebral microbleedsCortical microinfarctsCortical superficial siderosisHypertensive vasculopathyMagnetic resonance imaging

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