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Updated: Sep 22, 2025
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Microinfarcts in the Deep Gray Matter on 7T MRI: Risk Factors, MRI Correlates, and Relation to Cognitive
R Ghaznawi1,2, M H T Zwartbol1, J de Bresser3
1Form the Department of Radiology (R.G., M.H.T.Z., J.H.), University Medical Center Utrecht and Utrecht University, Utrecht, the Netherlands.
Background And Purpose:
The clinical relevance of cortical microinfarcts has recently been established; however, studies on microinfarcts in the deep gray matter are lacking. We examined the risk factors and MR imaging correlates of microinfarcts in the deep gray matter on 7T MR imaging and their relation to cognitive functioning.
Materials And Methods:
Within the Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study, 213 patients (mean age, 68 [SD, 8] years) had a risk-factor assessment, 7T and 1.5T brain MR imaging, and a cognitive examination. Microinfarcts on 7T MR imaging were defined as lesions of <5 mm. Regression models were used to examine the age-adjusted associations among risk factors, MR imaging markers, and microinfarcts. Cognitive function was summarized as composite and domain-specific z scores.
Results:
A total of 47 microinfarcts were found in 28 patients (13%), most commonly in the thalamus. Older age, history of stroke, hypertension, and intima-media thickness were associated with microinfarcts. On 1.5T MR imaging, cerebellar infarcts (relative risk = 2.75; 95% CI, 1.4-5.33) and lacunes in the white (relative risk = 3.28; 95% CI, 3.28-6.04) and deep gray matter (relative risk = 3.06; 95% CI, 1.75-5.35) were associated with microinfarcts, and on 7T MR imaging cortical microinfarcts (relative risk = 2.33; 95% CI, 1.32-4.13). Microinfarcts were also associated with poorer global cognitive functioning (mean difference in the global z score between patients with multiple microinfarcts versus none = -0.97; 95% CI, -1.66 to -0.28, P = .006) and across all cognitive domains.
Conclusions:
Microinfarcts in the deep gray matter on 7T MR imaging were associated with worse cognitive functioning and risk factors and MR imaging markers of small-vessel and large-vessel disease. Our findings suggest that microinfarcts in the deep gray matter may represent a novel imaging marker of vascular brain injury.
Insights
Deep gray matter microinfarcts, identified using 7T MRI, are linked to cognitive decline and vascular risk factors. These findings highlight deep gray matter microinfarcts as a potential marker for vascular brain injury.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Cortical microinfarcts are clinically relevant, but deep gray matter microinfarcts remain understudied.
- Investigating deep gray matter microinfarcts is crucial for understanding their role in brain health.
Purpose of the Study:
- To examine risk factors associated with deep gray matter microinfarcts.
- To identify MR imaging correlates of deep gray matter microinfarcts using 7T MRI.
- To explore the relationship between deep gray matter microinfarcts and cognitive function.
Main Methods:
- The Second Manifestations of ARTerial disease-Magnetic Resonance (SMART-MR) study included 213 patients with risk assessment, 1.5T and 7T brain MRI, and cognitive testing.
- Microinfarcts (<5 mm lesions) were identified on 7T MRI.
- Regression models analyzed associations between risk factors, imaging markers, and microinfarcts; cognitive function was assessed using z scores.
Main Results:
- 47 microinfarcts were found in 28 patients (13%), predominantly in the thalamus.
- Older age, stroke history, hypertension, and intima-media thickness correlated with microinfarcts.
- Deep gray matter microinfarcts were associated with poorer global cognitive functioning and all cognitive domains.
Conclusions:
- Deep gray matter microinfarcts on 7T MRI are linked to adverse cognitive outcomes.
- These microinfarcts correlate with risk factors and imaging markers of small- and large-vessel disease.
- Deep gray matter microinfarcts may serve as a novel imaging biomarker for vascular brain injury.
