Department of Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, The Netherlands.
Department of Neurology, J.P.K. Stroke Research Center, Massachusetts General Hospital, Boston, MA, USA.
J Alzheimers Dis. 2017;60(4):1443-1450. doi: 10.3233/JAD-170481.
Cerebral microinfarcts (CMIs) are small ischemic lesions that are a common neuropathological finding in patients with stroke or dementia. CMIs in the cortex can now be detected in vivo on 3 Tesla MRI.
To determine the occurrence of CMIs and associated clinical features in patients with possible vascular cognitive impairment (VCI).
182 memory-clinic patients (mean age 71.4±10.6, 55% male) with vascular injury on brain MRI (i.e., possible VCI) underwent a standardized work-up including 3 Tesla MRI and cognitive assessment. A control group consisted of 70 cognitively normal subjects (mean age 70.6±4.7, 60% male). Cortical CMIs and other neuroimaging markers of vascular brain injury were rated according to established criteria.
Occurrence of CMIs was higher (20%) in patients compared to controls (10%). Among patients, the presence of CMIs was associated with male sex, history of stroke, infarcts, and white matter hyperintensities. CMI presence was also associated with a diagnosis of vascular dementia and reduced performance in multiple cognitive domains.
CMIs on 3 Tesla MRI are common in patients with possible VCI and co-occur with imaging markers of small and large vessel disease, likely reflecting a heterogeneous etiology. CMIs are associated with worse cognitive performance, independent of other markers of vascular brain injury.
脑微梗死（CMI）是小的缺血性病变，是中风或痴呆患者常见的神经病理学发现。现在可以在 3T MRI 上活体检测到皮质中的 CMI。
确定可能患有血管性认知障碍（VCI）的患者中 CMI 的发生情况及其相关临床特征。
182 名记忆诊所患者（平均年龄 71.4±10.6，55%为男性）在脑 MRI 上有血管损伤（即可能的 VCI），接受了包括 3T MRI 和认知评估在内的标准化检查。对照组由 70 名认知正常的受试者组成（平均年龄 70.6±4.7，60%为男性）。根据既定标准评估皮质 CMI 和其他血管性脑损伤的神经影像学标志物。
与对照组（10%）相比，患者中 CMI 的发生率更高（20%）。在患者中，CMI 的存在与男性、中风、梗死和白质高信号有关。CMI 的存在也与血管性痴呆的诊断和多个认知领域的表现下降有关。
3T MRI 上的 CMI 在可能患有 VCI 的患者中很常见，与小血管和大血管疾病的影像学标志物同时存在，可能反映了一种异质性病因。CMI 与认知表现下降有关，与其他血管性脑损伤标志物无关。
