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J Cereb Blood Flow Metab. 2018 Sep;38(9):1609-1617. doi: 10.1177/0271678X17705974. Epub 2017 Apr 24.

Detection and characterization of small infarcts in the caudate nucleus on 7 Tesla MRI: The SMART-MR study.

Author information

1
1 Department of Radiology, University Medical Center Utrecht, the Netherlands.
2
2 Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, the Netherlands.

Abstract

Small infarcts are among the key imaging features of cerebral small vessel disease (CSVD), but remain largely undetected on conventional MRI. We aimed to evaluate (1) imaging criteria for the detection of small infarcts in the caudate nucleus on 7T MRI, (2) intra- and inter-rater agreement, (3) frequency and (4) detection rate on 7T versus 1.5T MRI. In 90 patients (68 ± 8 years) with a history of vascular disease from the SMART-MR study, we defined 7T imaging criteria for cavitated and non-cavitated small infarcts in the caudate nucleus. In a separate set of 23 patients from the SMART study, intra-rater and inter-rater agreement was excellent for presence, number, and individual locations (Kappa's, ICCs, and Dice similarity coefficients ranged from 0.85 to 1.00). In the 90 patients, 21 infarcts (20 cavitated) in 12 patients were detected on 7T (13%) compared to 7 infarcts in 6 patients on 1.5T (7%). In conclusion, we established reproducible imaging criteria for the detection of small infarcts in the caudate nucleus on 7T MRI and showed that 7T MRI allows for a higher detection rate than conventional 1.5T MRI. These imaging criteria can be used in future studies to provide new insights into the pathophysiology of CSVD.

KEYWORDS:

7 tesla MRI; Brain; cerebral infarcts; cerebrovascular disease; magnetic resonance imaging; small vessel disease

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