7.0 T MRI Detection of Cerebral Microinfarcts in Patients with a Symptomatic High-Grade Carotid artery Stenosis

Rotte, Alexandra A. J. de; Köning, W.; Hartog, A.G. den; Bovens, Sandra M.; Zwanenburg, Jaco J.M.; Klomp, Dennis W. J.; Pasterkamp, Gérard; Moll, Frans L.; Luijten, Peter R.; Borst, Gert J. de; Hendrikse, Jeroen

doi:10.1038/jcbfm.2014.141

Cited by 19 publications

(11 citation statements)

References 24 publications

(36 reference statements)

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“…We do not know whether other lesions outside the brain may have contributed to the observed infarcts and whether the ICAS we observe are innocent bystanders seen in older subjects with vascular risk factors. 31 Furthermore, the number of CMIs ranged from 0 to 33 in our patient group, which is in accordance with the results from histopathological studies. 32 It is noteworthy to mention that histopathological studies sample only a very small portion of the brain.…”

Section: Discussionsupporting

confidence: 90%

Relations between location and type of intracranial atherosclerosis and parenchymal damage

Dieleman

Kolk

Zwanenburg

et al. 2015

J Cereb Blood Flow Metab

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The aim of this study was to assess the relation between location and type of intracranial atherosclerosis (ICAS) and cortical microinfarcts (CMIs) and macroinfarcts in 18 patients presenting with ischemic stroke (n = 12) or transient ischemic attack (TIA) (n = 6) using 7 tesla MR imaging. The protocol included: 3D T2-weighted FLAIR and 3D T1-weighted Magnetization-Preparation Inversion Recovery Turbo Spin Echo sequence. ICAS lesions and infarcts were scored by two raters. The relation between ICAS lesions, calculated ratios of ICAS lesion characteristics, location, and infarcts were examined using linear regression analyses. A total number of 75 ICAS lesions (all patients), 101 CMIs (78% of patients), and 31 macroinfarcts (67% of patients) were found. Seventy-six and sixty-five percent of the CMIs and macroinfarcts, respectively, were found in the same vascular territory as the ICAS lesions (p = 0.977, p = 0.167, respectively). A positive correlation existed between the number of macroinfarcts and CMIs (p < 0.05). In patients with macroinfarcts, we found more concentric (p < 0.01) and diffuse (p < 0.05) type of ICAS lesions. A high prevalence of brain tissue lesions, both macroinfarcts and CMIs, were found in patients with ICAS. Macroinfarcts were found to be related to specific ICAS lesion types. The type of ICAS lesion seems to be promising as a marker for ICAS patients at higher risk of future infarcts.

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Section: Discussionsupporting

confidence: 90%

Relations between location and type of intracranial atherosclerosis and parenchymal damage

Dieleman

Kolk

Zwanenburg

et al. 2015

J Cereb Blood Flow Metab

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“…5 ) ( van Veluw et al, 2015) . CMIs are associated with atherosclerosis, and are believed to be of microembolic origin ( Zheng et al, 2013 ; Raman et al, 2014 ; Rotte et al, 2014) . Also, CMIs are a new marker of vascular dementia, especially if occurring in strategic locations, such as the inferior frontal and cingulate gyri ( van Veluw et al, 2015 ; De Reuck et al, 2014 , 2016).…”

Section: Clinical Applicationsmentioning

confidence: 99%

Clinical vascular imaging in the brain at 7 T

et al. 2018

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Stroke and related cerebrovascular diseases are a major cause of mortality and disability. Even at standard-field-strengths (1.5 T), MRI is by far the most sensitive imaging technique to detect acute brain infarctions and to characterize incidental cerebrovascular lesions, such as white matter hyperintensities, lacunes and microbleeds. Arterial time-of-flight (TOF) MR angiography (MRA) can depict luminal narrowing or occlusion of the major brain feeding arteries, and this without the need for contrast administration. Compared to 1.5 T MRA, the use of high-field strength (3 T) and even more so ultra-high-field strengths (7 T), enables the visualization of the lumen of much smaller intracranial vessels, while adding a contrast agent to TOF MRA at 7 T may enable the visualization of even more distal arteries in addition to veins and venules. Moreover, with 3 T and 7 T, the arterial vessel walls beyond the circle of Willis become visible with high-resolution vessel wall imaging. In addition, with 7 T MRI, the brain parenchyma can now be visualized on a submillimeter scale. As a result, high-resolution imaging studies of the brain and its blood supply at 7 T have generated new concepts of different cerebrovascular diseases. In the current article, we will discuss emerging clinical applications and future directions of vascular imaging in the brain at 7 T MRI.

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“…However, there is a major drawback in terms of time of accumulation of USPIO at the lesion site, which could go up to 24 h [89]. As a potential future direction of research, correlation between cerebral damage which can be accurately detected by MRI and presence of high grade carotid stenosis (> 50%) could prove to be an efficient method of CAS diagnosis [90].…”

Section: Introductionmentioning

confidence: 99%

Imaging modalities to diagnose carotid artery stenosis: progress and prospect

2019

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In the past few decades, imaging has been developed to a high level of sophistication. Improvements from one-dimension (1D) to 2D images, and from 2D images to 3D models, have revolutionized the field of imaging. This not only helps in diagnosing various critical and fatal diseases in the early stages but also contributes to making informed clinical decisions on the follow-up treatment profile. Carotid artery stenosis (CAS) may potentially cause debilitating stroke, and its accurate early detection is therefore important. In this paper, the technical development of various CAS diagnosis imaging modalities and its impact on the clinical efficacy is thoroughly reviewed. These imaging modalities include duplex ultrasound (DUS), computed tomography angiography (CTA) and magnetic resonance angiography (MRA). For each of the imaging modalities considered, imaging methodology (principle), critical imaging parameters, and the extent of imaging the vulnerable plaque are discussed. DUS is usually the initial recommended CAS diagnostic examination. However, for the therapeutic intervention, either MRA or CTA is recommended for confirmation, and for added information on intracranial cerebral circulation and aortic arch condition for procedural planning. Over the past few decades, the focus of CAS diagnosis has also shifted from pure stenosis quantification to plaque characterization. This has led to further advancement in the existing imaging tools and development of other potential imaging tools like Optical coherence tomography (OCT), photoacoustic tomography (PAT), and infrared (IR) thermography.

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7.0 T MRI Detection of Cerebral Microinfarcts in Patients with a Symptomatic High-Grade Carotid artery Stenosis

Cited by 19 publications

References 24 publications

Relations between location and type of intracranial atherosclerosis and parenchymal damage

Relations between location and type of intracranial atherosclerosis and parenchymal damage

Clinical vascular imaging in the brain at 7 T

Imaging modalities to diagnose carotid artery stenosis: progress and prospect

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