van Veluw Susanne J, Zwanenburg Jaco J M, Rozemuller Annemieke Jm, Luijten Peter R, Spliet Wim G M, Biessels Geert Jan
Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands.
J Cereb Blood Flow Metab. 2015 Mar 31;35(4):676-83. doi: 10.1038/jcbfm.2014.258.
Cerebral microinfarcts (CMIs) are common neuropathologic findings in aging and dementia. We explored the spectrum of cortical CMIs that can be visualized with 7 T magnetic resonance imaging (MRI). Thirty-three coronal brain slices of 11 individuals with neuropathologically confirmed dementia were subjected to a high-resolution postmortem 7 T MRI protocol. First, we identified all visible small (⩽ 5 mm) intracortical and juxtacortical lesions on postmortem MRI. Lesions were classified as CMI or nonCMI based on histology, and their MR features were recorded. Thirty lesions were identified on the initial MRI evaluation, of which twenty-three could be matched with histology. Histopathology classified 12 lesions as CMIs, all of which were located intracortically. On the basis of their MR features, they could be classified as chronic gliotic CMIs--with or without cavitation or hemorrhagic components--and acute CMIs. Eleven MRI identified lesions were not of ischemic nature and most commonly enlarged or atypically shaped perivascular spaces. Their MRI features were similar to gliotic CMIs with or without cavitation, but these 'CMI mimics' were always located juxtacortically. 7 T postmortem MRI distinguishes different histopathologic types of cortical CMIs, with distinctive MR characteristics. On the basis of our findings, we propose in vivo rating criteria for the detection of intracortical CMIs.
脑微梗死（CMIs）是衰老和痴呆常见的神经病理学表现。我们探索了利用7T磁共振成像（MRI）能够可视化的皮质CMIs的范围。对11例经神经病理学确诊为痴呆的个体的33个冠状位脑切片进行了高分辨率的死后7T MRI检查。首先，我们在死后MRI上识别出所有可见的小（≤5mm）皮质内和皮质旁病变。根据组织学将病变分类为CMI或非CMI，并记录其MR特征。在最初的MRI评估中识别出30个病变，其中23个可与组织学匹配。组织病理学将12个病变分类为CMIs，所有这些病变均位于皮质内。根据其MR特征，它们可分类为慢性胶质化CMIs（有或无空洞或出血成分）和急性CMIs。11个MRI识别出的病变并非缺血性，最常见的是扩大或形状异常的血管周围间隙。它们的MRI特征与有或无空洞的胶质化CMIs相似，但这些“CMI模仿物”总是位于皮质旁。7T死后MRI可区分不同组织病理学类型的皮质CMIs，具有独特的MR特征。根据我们的研究结果，我们提出了检测皮质内CMIs的活体评级标准。
