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Updated: Sep 19, 2025
Assessing Cortical Cerebral Microinfarcts on High Resolution MR Images
Published on: November 20, 2015
Cortical Cerebral Microinfarcts in Spontaneous Intracerebral Hemorrhage on 3T and 7T MRI
Wilmar M T Jolink1, Susanne J van Veluw2, Doeschka A Ferro3
1Department of Neurology, Isala, Zwolle, the Netherlands.
Background And Objectives:
MRI markers of cerebral small vessel disease (cSVD) in patients with spontaneous intracerebral hemorrhage (sICH) have provided insight in the underlying vascular pathology. Cortical cerebral microinfarcts (CMIs) are a relatively novel marker of cSVD. We aimed to assess presence and location within the cortex of CMIs in patients with sICH on 3T and 7T MRI, and to determine their association with hematoma location and other neuroimaging markers of cSVD.
Methods:
From a multicenter prospective observational cohort study, we included consecutive adult patients who underwent 3T and/or 7T MRI within 3 months after sICH. We determined presence and location of CMIs within the cortex (superficial or deeper layers; on 7T MRI) and assessed associations between presence of cortical CMIs and vascular risk factors, hematoma location, and other MRI markers of cSVD with multiple regression analyses.
Results:
We included 135 patients (mean age 63 years; 30% female). On 3T MRIs, we found 100 cortical CMIs in 57 patients (42%, median number 2, interquartile range [IQR] 1-3; lobar ICH 24 of 58 patients [41%]; non-lobar ICH 33 of 77 patients [43%]). On 7T MRI images, we found 59 cortical CMIs in 28 of 40 patients (70%; median number of 2, IQR 1-3; lobar ICH 8 of 12 patients [67%]; non-lobar ICH 20 of 28 patients [71%]). Presence of cortical CMIs was associated with history of TIA/ischemic stroke (relative risk [RR] 2.7, 95% CI 1.1-6.4), but not with other vascular risk factors or any of the MRI markers of cSVD. On 7T MRI, CMIs were located in the superficial part of the cortex in 30% of patients with lobar vs 5% of patients with non-lobar ICH (RR 2.7, 95% CI 1.5-5.0).
Discussion:
Cortical CMIs are a common finding in patients with sICH on both 3T and 7T MRIs with a similar frequency in patients with lobar and non-lobar sICH. Patients with lobar sICH, more often have CMIs in the superficial part of the cortex than those with non-lobar sICH. Location of CMIs within the cortex might provide insight into the underlying type of small vessel disease in sICH.
Insights
Cortical cerebral microinfarcts (CMIs) are common in patients with spontaneous intracerebral hemorrhage (sICH). Their location within the cortex may indicate the type of small vessel disease in sICH.
Area of Science:
- Neurology
- Radiology
- Vascular Medicine
Background:
- Cerebral small vessel disease (cSVD) is implicated in spontaneous intracerebral hemorrhage (sICH).
- Cortical cerebral microinfarcts (CMIs) are emerging as a novel marker of cSVD.
- Understanding CMI presence and location in sICH patients is crucial for elucidating underlying pathology.
Purpose of the Study:
- To assess the presence and cortical location of CMIs in sICH patients using 3T and 7T MRI.
- To determine the association of CMIs with hematoma location and other cSVD markers.
Main Methods:
- Prospective observational cohort study including 135 sICH patients.
- 3T and/or 7T MRI scans were performed within 3 months post-ICH.
- Multiple regression analyses assessed associations between CMIs, vascular risk factors, hematoma location, and cSVD markers.
Main Results:
- Cortical CMIs were detected in 42% of patients on 3T MRI and 70% on 7T MRI.
- CMI presence was associated with a history of TIA/ischemic stroke (RR 2.7).
- On 7T MRI, CMIs were more frequent in the superficial cortex of lobar ICH patients (30%) compared to non-lobar ICH patients (5%).
Conclusions:
- Cortical CMIs are frequently found in sICH patients on both 3T and 7T MRI.
- CMI frequency was similar in lobar and non-lobar sICH.
- Cortical CMI location may offer insights into the specific type of small vessel disease contributing to sICH.
