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Updated: Aug 13, 2026
A Magnetic Resonance Imaging Protocol for Stroke Onset Time Estimation in Permanent Cerebral Ischemia
Published on: September 16, 2017
Association between acute infarct topography and cerebral microbleed location in acute ischemic stroke: a
Lingzhi Cheng1, Yuewan Fu2, Yichao Wu2
1Department of Radiology, Beijing Longfu Hospital, Beijing, China.
Background:
Cerebral microbleeds (CMBs) are important imaging markers of cerebral small vessel disease and are frequently detected in patients with stroke. However, imaging evidence regarding spatial associations between infarct topography and CMBs detected on the index magnetic resonance imaging (MRI) examination in patients with acute ischemic stroke (AIS) remains limited. This study aims to investigate the association between acute infarct location and CMB location on brain MRI.
Methods:
This retrospective cross-sectional study included cranial MRI data from patients with AIS. Acute infarcts were identified on diffusion-weighted imaging/apparent diffusion coefficient (DWI/ADC) and classified into six predefined neuroanatomical regions. CMBs detected on the index MRI examination were identified on susceptibility-weighted imaging (SWI) and recorded using the same regional scheme. Two experienced readers independently interpreted the images under blinded conditions, and disagreements were resolved by consensus adjudication. Multivariable logistic regression was performed to evaluate factors associated with the presence of CMBs after limited adjustment for sex, age, and infarct location. Exploratory regression analyses were further performed to assess associations between infarct location and region-specific CMBs.
Results:
A total of 138 patients with AIS were included, among whom 79 (57.2%) had CMBs detected on SWI. In multivariable logistic regression analysis, after limited adjustment for sex, age, and infarct location, corona radiata infarction was associated with the presence of CMBs [odds ratio (OR) =3.61, 95% confidence interval (CI): 1.52-8.61, P=0.004]. Exploratory univariable analyses showed that cortical infarction was associated with cortical CMBs (OR =2.90, 95% CI: 1.37-6.13, P=0.005), while corona radiata infarction was associated with corona radiata CMBs (OR =3.82, 95% CI: 1.83-8.00, P<0.001). In addition, increasing age (OR =1.11, 95% CI: 1.02-1.20, P=0.013) and thalamic infarction (OR =5.36, 95% CI: 1.18-24.46, P=0.030) showed exploratory associations with cerebellar CMBs.
Conclusions:
In this retrospective single-center MRI study, corona radiata infarction was associated with CMBs detected on the index MRI examination after limited adjustment for demographic variables and infarct location. Region-specific associations between acute infarct location and CMB location were exploratory and should be interpreted cautiously, given the cross-sectional design, limited covariate adjustment, small sample size, and potential scanner heterogeneity. Further prospective multicenter studies using standardized MRI protocols and more comprehensive clinical and imaging covariates are needed to validate these findings.
Insights
Cerebral microbleeds (CMBs) are linked to stroke location, particularly in the corona radiata. This study found associations between infarct and microbleed locations in acute ischemic stroke patients.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Cerebral microbleeds (CMBs) are key indicators of cerebral small vessel disease.
- CMBs are frequently observed in stroke patients, but spatial associations with infarcts are understudied.
- Acute ischemic stroke (AIS) patients often have CMBs, necessitating research into their location relative to infarcts.
Purpose of the Study:
- To investigate the spatial association between acute infarct location and cerebral microbleed (CMB) location in patients with acute ischemic stroke (AIS).
- To determine if specific infarct locations correlate with CMB presence and location on magnetic resonance imaging (MRI).
Main Methods:
- Retrospective cross-sectional study of cranial MRI data from 138 AIS patients.
- Acute infarcts identified on DWI/ADC and CMBs on SWI, classified into six neuroanatomical regions.
- Independent blinded image interpretation by two readers, with consensus for disagreements; multivariable logistic regression used for analysis.
Main Results:
- 79 (57.2%) of AIS patients had detectable CMBs.
- Corona radiata infarction was significantly associated with the presence of CMBs (OR=3.61).
- Exploratory analyses revealed associations between cortical infarcts and cortical CMBs, and corona radiata infarcts and CMBs, alongside age and thalamic infarcts with cerebellar CMBs.
Conclusions:
- Corona radiata infarction is associated with CMBs in AIS patients, even after adjusting for demographic factors.
- Region-specific infarct and CMB location associations require cautious interpretation due to study limitations.
- Further prospective, multicenter studies with standardized protocols are needed to validate these findings.
