In vivo Detection of Cortical Microinfarcts on Ultrahigh-Field MRI
In vivo Detection of Cortical Microinfarcts on Ultrahigh-Field MRI
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DOI：
10.1111/j.1552-6569.2012.00722.x
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发表时间：
2013-01-01
影响因子：
2.4
通讯作者：
Tomimoto, Hidekazu
中科院分区：
文献类型：
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作者：
Ii, Yuichiro;Maeda, Masayuki;Tomimoto, Hidekazu
背景和目的在尸检脑中发现的皮质微梗死（CMI）是局限于大脑皮质的小病灶。CMI被认为是由老年人的脑淀粉样血管病（CAA）引起的，可能是痴呆症的风险。我们的目的是可视化CMI，这在传统的MRI上是不可见的，使用双反转恢复（DWI）和三维液体衰减反转恢复（3D-FLAIR）在3特斯拉MRI。方法对70例阿尔茨海默病（AD; n = 47）、轻度认知功能障碍（n = 14）、AD伴脑血管病（CVD; n = 3）、血管性痴呆（VaD; n = 2）、CAA相关性脑出血（ICH; n = 2）以及正常压力脑积水和路易体痴呆（DLB）各1例患者前瞻性地进行了MRI和3D-FLAIR成像。磁敏感加权成像（SWI）检测脑微出血（CMB）。结果9例受试者（AD患者5例，AD合并CVD、ICH、VaD和DLB各1例）在MRI和3D-FLAIR图像上均显示皮质内小的高信号病变。所有9例患者均伴有多个肺叶CMB。这些皮质内病变位于CMB附近，建议为CMI。结论MRI和3D-FLAIR图像可能为显示CMI开辟了一条途径。
BACKGROUND AND PURPOSE Cortical microinfarcts (CMIs) are detected as small foci restricted to the cerebral cortex in autopsy brains. CMIs are thought to be caused by cerebral amyloid angiopathy (CAA) in the elderly and may be a risk for dementia. We aimed to visualize CMIs, which remain invisible on conventional MRI, using double inversion recovery (DIR) and 3-dimensional fluid attenuated inversion recovery (3D-FLAIR) on 3-Tesla MRI. METHODS We prospectively performed DIR and 3D-FLAIR images in 70 subjects with Alzheimer disease (AD; n = 47), mild cognitive impairment (n = 14), AD with cerebrovascular disease (CVD; n = 3), vascular dementia (VaD; n = 2), CAA-associated intracerebral hemorrhage (ICH; n = 2) and one each of normal pressure hydrocephalus and dementia with Lewy bodies (DLB). Susceptibility-weighted imaging (SWI) was performed to detect cerebral microbleeds (CMBs). RESULTS Nine subjects (five of AD and one each of AD with CVD, ICH, VaD, and DLB) had small intracortical high signal lesions on both DIR and 3D-FLAIR images. All the nine subjects accompanied multiple lobar CMBs. These intracortical lesions were located in close proximity to CMBs, and were suggested to be CMIs. CONCLUSIONS DIR and 3D-FLAIR images may open a way to visualize CMIs.