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Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
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Acute Cerebral Microinfarcts in Acute Ischemic Stroke: Imaging and Clinical Significance

Wendan Tao1, Zhetao Wang2, Junfeng Liu3

  • 1Department of Neurology, West China Hospital, Sichuan University, Chengdu, China, 58790214@qq.com.

Cerebrovascular Diseases (Basel, Switzerland)
|May 1, 2022
PubMed
Abstract

Insights

Acute cerebral microinfarcts (A-CMIs) are found in nearly half of acute ischemic stroke (AIS) patients. These microinfarcts are linked to microembolism and cerebral small vessel disease, impacting stroke etiology.

Area of Science:

  • Neurology
  • Radiology
  • Stroke Medicine

Background:

  • Limited data exist on acute cerebral microinfarcts (A-CMIs) in acute ischemic stroke (AIS).
  • Understanding A-CMIs' significance in AIS is crucial for prognosis.

Purpose of the Study:

  • To determine the profile and prognostic significance of A-CMIs on MRI in AIS patients.
  • To investigate the association between A-CMIs and stroke etiology.

Main Methods:

  • Prospective single-center study of 273 AIS patients with 3T MRI.
  • Classified A-CMIs presence, number, and location; assessed markers of cerebral small vessel disease (CSVD), macroinfarcts, and etiology (cardioembolism [CE], large artery atherosclerosis [LAA]).

Main Results:

  • A-CMIs detected in 47.6% of patients; cortical A-CMIs in 73.0% of those with A-CMIs.
  • Patients with A-CMIs were older, less diabetic, and more likely to have atrial fibrillation and embolic sources (LAA/CE).
  • Embolic sources (LAA/CE) independently associated with cortical A-CMIs; lacunes related to subcortical A-CMIs.

Conclusions:

  • A-CMIs are prevalent in nearly half of AIS patients, occurring in cortical and subcortical regions.
  • Microembolism is the presumed mechanism for cortical A-CMIs; CSVD for subcortical A-CMIs.
Keywords:
Acute ischemic strokeEmbolismMagnetic resonance imagingMicroinfarctsSmall vessel disease

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