TY - JOUR
T1 - Detection of Cerebral Microbleeds With Venous Connection at 7 Tesla MRI
AU - Rotta, Johanna
AU - Perosa, Valentina
AU - Yakupov, Renat
AU - Kuijf, Hugo J
AU - Schreiber, Frank
AU - Dobisch, Laura
AU - Oltmer, Jan
AU - Assmann, Anne
AU - Speck, Oliver
AU - Heinze, Hans-Jochen
AU - Acosta-Cabronero, Julio
AU - Düzel, Emrah
AU - Schreiber, Stefanie
N1 - Publisher Copyright:
© American Academy of Neurology.
PY - 2021/4/20
Y1 - 2021/4/20
N2 - OBJECTIVE: Cerebral microbleeds (MBs) are a common finding in patients with cerebral small vessel disease (CSVD) and Alzheimer disease as well as in healthy elderly people, but their pathophysiology remains unclear. To investigate a possible role of veins in the development of MBs, we performed an exploratory study, assessing in vivo presence of MBs with a direct connection to a vein.METHODS: 7-Tesla (7T) MRI was conducted and MBs were counted on quantitative susceptibility mapping (QSM). A submillimeter resolution QSM-based venogram allowed identification of MBs with a direct spatial connection to a vein.RESULTS: A total of 51 people (mean age [SD] 70.5 [8.6] years, 37% female) participated in the study: 20 had CSVD (cerebral amyloid angiopathy [CAA] with strictly lobar MBs [n = 8], hypertensive arteriopathy [HA] with strictly deep MBs [n = 5], or mixed lobar and deep MBs [n = 7], 72.4 [6.1] years, 30% female) and 31 were healthy controls (69.4 [9.9] years, 42% female). In our cohort, we counted a total of 96 MBs with a venous connection, representing 14% of all detected MBs on 7T QSM. Most venous MBs (86%, n = 83) were observed in lobar locations and all of these were cortical. Patients with CAA showed the highest ratio of venous to total MBs (19%) (HA = 9%, mixed = 18%, controls = 5%).CONCLUSION: Our findings establish a link between cerebral MBs and the venous vasculature, pointing towards a possible contribution of veins to CSVD in general and to CAA in particular. Pathologic studies are needed to confirm our observations.
AB - OBJECTIVE: Cerebral microbleeds (MBs) are a common finding in patients with cerebral small vessel disease (CSVD) and Alzheimer disease as well as in healthy elderly people, but their pathophysiology remains unclear. To investigate a possible role of veins in the development of MBs, we performed an exploratory study, assessing in vivo presence of MBs with a direct connection to a vein.METHODS: 7-Tesla (7T) MRI was conducted and MBs were counted on quantitative susceptibility mapping (QSM). A submillimeter resolution QSM-based venogram allowed identification of MBs with a direct spatial connection to a vein.RESULTS: A total of 51 people (mean age [SD] 70.5 [8.6] years, 37% female) participated in the study: 20 had CSVD (cerebral amyloid angiopathy [CAA] with strictly lobar MBs [n = 8], hypertensive arteriopathy [HA] with strictly deep MBs [n = 5], or mixed lobar and deep MBs [n = 7], 72.4 [6.1] years, 30% female) and 31 were healthy controls (69.4 [9.9] years, 42% female). In our cohort, we counted a total of 96 MBs with a venous connection, representing 14% of all detected MBs on 7T QSM. Most venous MBs (86%, n = 83) were observed in lobar locations and all of these were cortical. Patients with CAA showed the highest ratio of venous to total MBs (19%) (HA = 9%, mixed = 18%, controls = 5%).CONCLUSION: Our findings establish a link between cerebral MBs and the venous vasculature, pointing towards a possible contribution of veins to CSVD in general and to CAA in particular. Pathologic studies are needed to confirm our observations.
KW - Aged
KW - Cerebral Hemorrhage/diagnostic imaging
KW - Cerebral Small Vessel Diseases/complications
KW - Female
KW - Humans
KW - Image Interpretation, Computer-Assisted
KW - Magnetic Resonance Imaging
KW - Male
KW - Middle Aged
KW - Neuroimaging/methods
KW - Veins/diagnostic imaging
UR - http://www.scopus.com/inward/record.url?scp=85106540083&partnerID=8YFLogxK
U2 - 10.1212/WNL.0000000000011790
DO - 10.1212/WNL.0000000000011790
M3 - Article
C2 - 33653897
SN - 0028-3878
VL - 96
SP - e2048-e2057
JO - Neurology
JF - Neurology
IS - 16
ER -