title: 7.0 T MRI detection of cerebral microinfarcts in patients with a symptomatic high-grade carotid artery stenosis.
abstract: In the current study, the presence of cerebral cortical microinfarcts (CMIs) was evaluated in a series of 21 patients with a symptomatic high-grade >50% stenosis of the carotid artery. A T2-weighted fluid-attenuated inversion recovery sequence and a T1-weighted turbo field echo sequence of the brain were obtained at 7.0 Tesla magnetic resonance imaging. Primary study endpoint was the number of CMIs and macroinfarcts. In total, 53 cerebral infarcts (35 macroinfarcts; 18 CMIs) were found ipsilateral to the symptomatic carotid artery, in 14 patients (67%). In four of these patients, both CMIs and macroinfarcts were visible. In the contralateral hemisphere, seven infarcts (five macroinfarcts and two CMIs) were found in five patients (24%). In the ipsilateral hemispheres, the number of CMIs and macroinfarcts were significantly correlated (P=0.02). Unpaired comparison of medians showed that the number of CMIs in the ipsilateral hemisphere was significantly higher than the number of CMIs in the contralateral hemisphere (P=0.04). No significant correlation was found between stenosis grade and the number of any infarct. The current study shows that in symptomatic patients with significant extracranial carotid artery stenosis, CMIs are part of the total cerebrovascular burden and these CMIs prevail with a similar pattern as observed macroinfarcts.
authors: Department of Radiology, University Medical Center, Utrecht, The Netherlands.
authors: Alexandra A J
authors: AA
authors: de Rotte
authors: Department of Radiology, University Medical Center, Utrecht, The Netherlands.
authors: Wouter
authors: W
authors: Koning
authors: Department of Vascular Surgery, University Medical Center, Utrecht, The Netherlands.
authors: Anne G
authors: AG
authors: den Hartog
authors: Bioengineering Department, Imperial College, London, UK.
authors: Sandra M
authors: SM
authors: Bovens
authors: Department of Radiology, University Medical Center, Utrecht, The Netherlands.
authors: Jaco J M
authors: JJ
authors: Zwanenburg
authors: Department of Radiology, University Medical Center, Utrecht, The Netherlands.
authors: Dennis W J
authors: DW
authors: Klomp
authors: Department of Experimental Cardiology, University Medical Center, Utrecht, The Netherlands.
authors: Gerard
authors: G
authors: Pasterkamp
authors: Department of Vascular Surgery, University Medical Center, Utrecht, The Netherlands.
authors: Frans L
authors: FL
authors: Moll
authors: Department of Radiology, University Medical Center, Utrecht, The Netherlands.
authors: Peter R
authors: PR
authors: Luijten
authors: Department of Vascular Surgery, University Medical Center, Utrecht, The Netherlands.
authors: Gert Jan
authors: GJ
authors: de Borst
authors: Department of Radiology, University Medical Center, Utrecht, The Netherlands.
authors: Jeroen
authors: J
authors: Hendrikse
mesh_terms: D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology*; D016893:Carotid Stenosis / Q000150:complications / Q000473:pathology*; D002544:Cerebral Infarction / Q000150:complications / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged