Implications of quantitative susceptibility mapping at 7 Tesla MRI for microbleeds detection in cerebral small vessel disease

Perosa, Valentina; Rotta, Johanna; Yakupov, Renat; Kuijf, Hugo J.; Schreiber, Frank; Oltmer, Jan; Mattern, Hendrik; Heinze, Hans‐Jochen; Düzel, Emrah; Schreiber, Stefanie

doi:10.3389/fneur.2023.1112312

Cited by 3 publications

(2 citation statements)

References 61 publications

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“…Two of 9 were CMB mimics (1 microaneurysm and 1 calcification), which is consistent with the previously described heterogeneity of the pathological correlates of lobar CMBs 31 . Calcifications have been observed on in vivo imaging of small vessel disease patients 32 and in hereditary Dutch‐type CAA, where they were regarded as a marker of advanced pathology 33 …”

Section: Discussionsupporting

confidence: 84%

Histopathological Correlates of Lobar Microbleeds in False‐Positive Cerebral Amyloid Angiopathy Cases

Perosa,

Auger,

Zanon Zotin

et al. 2023

Annals of Neurology

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ObjectiveA definite diagnosis of cerebral amyloid angiopathy (CAA), characterized by the accumulation of Amyloid‐β in walls of cerebral small vessels, can only be obtained through pathological examination. A diagnosis of probable CAA during life relies on the presence of haemorrhagic markers, including lobar cerebral microbleeds (CMBs). The aim of this project was to study the histopathological correlates of lobar CMBs in false‐positive CAA cases.MethodsIn three patients who met criteria for probable CAA during life, but showed no CAA upon neuropathological examination, lobar CMBs were counted on ex vivo 3 T MRI and on ex vivo 7 T MRI. Areas with lobar CMBs were next sampled and cut in serial sections, on which the CMBs were then identified.ResultsCollectively, there were 25 lobar CMBs on in vivo MRI and 22 on ex vivo 3 T MRI of the analysed hemispheres. On ex vivo MRI we targeted 12 CMBs for sampling and definite histopathological correlates were retrieved for 9 of them of which seven were true CMBs. No CAA was found on any of the serial sections. The ‘culprit vessels’ associated with the true CMBs instead showed moderate to severe arteriolosclerosis. Furthermore, CMBs in false‐positive CAA cases tended to be located more often in the juxtacortical or subcortical white matter, than in the cortical ribbon.InterpretationThese findings suggest that arteriolosclerosis can generate lobar CMBs and that more detailed investigations into the exact localization of CMBs with respect to the cortical ribbon could potentially aid the diagnosis of CAA during life.This article is protected by copyright. All rights reserved.

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Section: Discussionsupporting

confidence: 84%

Histopathological Correlates of Lobar Microbleeds in False‐Positive Cerebral Amyloid Angiopathy Cases

Perosa,

Auger,

Zanon Zotin

et al. 2023

Annals of Neurology

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“…Among new and advanced neuroimaging techniques, in future studies it would be interesting to use the technique of Quantitative Susceptibility mapping (QSM). This method has been widely used for the quantification of cSS and CMBs in cSVD and it allow the detection of a higher number of CMBs and the differentiation of CMBs from calcifications 36 , 37 . A third limitation pertains the possibility that our inclusion criteria could results in potential selection biases.…”

Section: Discussionmentioning

confidence: 99%

Cognitive profile in cerebral small vessel disease: comparison between cerebral amyloid angiopathy and hypertension-related microangiopathy

Barucci,

Salvadori,

Magi

et al. 2024

Sci Rep

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Cerebral amyloid angiopathy (CAA) is recognized as a cause of cognitive impairment, but its cognitive profile needs to be characterized, also respect to hypertension-related microangiopathy (HA). We aimed at comparing difference or similarity of CAA and HA patients’ cognitive profiles, and their associated factors. Participants underwent an extensive clinical, neuropsychological, and neuroimaging protocol. HA patients (n = 39) were more frequently males, with history of vascular risk factors than CAA (n = 32). Compared to HA, CAA patients presented worse performance at MoCA (p = 0.001) and semantic fluency (p = 0.043), and a higher prevalence of amnestic MCI (46% vs. 68%). In univariate analyses, multi-domain MCI was associated with worse performance at MoCA, Rey Auditory Verbal Learning Test (RAVLT), and semantic fluency in CAA patients, and with worse performance at Symbol Digit Modalities Test (SDMT) and phonemic fluency in HA ones. In multivariate models, multi-domain deficit remained as the only factor associated with RAVLT (β = − 0.574) in CAA, while with SDMT (β = − 0.364) and phonemic fluency (β = − 0.351) in HA. Our results highlight different patterns of cognitive deficits in CAA or HA patients. While HA patients’ cognitive profile was confirmed as mainly attentional/executive, a complex cognitive profile, characterized also by deficit in semantic memory, seems the hallmark of CAA patients.

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Enlarged perivascular spaces in the basal ganglia are associated with arteries not veins

Oltmer,

Mattern,

Beck

et al. 2024

J Cereb Blood Flow Metab

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Enlarged perivascular spaces (EPVS) are common in cerebral small vessel disease (CSVD) and have been identified as a marker of dysfunctional brain clearance. However, it remains unknown if the enlargement occurs predominantly around arteries or veins. We combined in vivo ultra-high-resolution MRI and histopathology to investigate the spatial relationship of veins and arteries with EPVS within the basal ganglia (BG). Furthermore, we assessed the relationship between the EPVS and measures of blood-flow (blood-flow velocity, pulsatility index) in the small arteries of the BG. Twenty-four healthy controls, twelve non-CAA CSVD patients, and five probable CAA patients underwent a 3 tesla [T] and 7T MRI-scan, and EPVS, arteries, and veins within the BG were manually segmented. Furthermore, the scans were co-registered. Six autopsy-cases were also assessed. In the BG, EPVS were significantly closer to and overlapped more frequently with arteries than with veins. Histological analysis showed a higher proportion of BG EPVS surrounding arteries than veins. Finally, the pulsatility index of BG arteries correlated with EPVS volume. Our results are in line with previous works and establish a pathophysiological relationship between arteries and EPVS, contributing to elucidating perivascular clearance routes in the human brain.

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Implications of quantitative susceptibility mapping at 7 Tesla MRI for microbleeds detection in cerebral small vessel disease

Cited by 3 publications

References 61 publications

Histopathological Correlates of Lobar Microbleeds in False‐Positive Cerebral Amyloid Angiopathy Cases

Histopathological Correlates of Lobar Microbleeds in False‐Positive Cerebral Amyloid Angiopathy Cases

Cognitive profile in cerebral small vessel disease: comparison between cerebral amyloid angiopathy and hypertension-related microangiopathy

Enlarged perivascular spaces in the basal ganglia are associated with arteries not veins

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