Role of Low-Field Portable MRI in Small Vessel Disease Identification

Cerebral small vessel disease (SVD) is the most common age-related brain pathology. Magnetic resonance imaging (MRI) is the reference standard for identifying SVD biomarkers, including white matter hyperintensity, recent small subcortical infarcts, lacunes, perivascular spaces, cerebral microbleeds, and cortical superficial siderosis. However, SVD is usually detected only when patients undergo conventional high-field MRI, limiting early identification, longitudinal monitoring, and equitable access to brain health evaluation. Low-field portable MRI systems (<0.1T) offer point-of-care acquisition with reduced infrastructure requirements and have demonstrated concordance with conventional MRI for multiple acute brain pathologies. We review the emerging evidence for portable MRI-based detection of SVD features, with an emphasis on white matter hyperintensity. Future portable MRI work on SVD should prioritize longitudinal validation, standardized reporting, and integration into pragmatic vascular prevention trials.