Early MRI imaging and follow-up study in cerebral amyloid angiopathy

Shan-Chun Zhang; Jian-Jun Jia; Heng-Li Zhao; Bo Zhou; Wei Wang; Xiang-Hui Lu; Hao Wang; Zhen-Fu Wang; Wei-Ping Wu

doi:10.1515/med-2021-0212

Early MRI imaging and follow-up study in cerebral amyloid angiopathy

Open Med (Wars). 2021 Feb 2;16(1):257-263. doi: 10.1515/med-2021-0212. eCollection 2021.

Authors

Shan-Chun Zhang¹, Jian-Jun Jia¹, Heng-Li Zhao¹, Bo Zhou¹, Wei Wang¹, Xiang-Hui Lu¹, Hao Wang², Zhen-Fu Wang¹, Wei-Ping Wu¹

Affiliations

¹ Geriatric Neurological Department of the Second Medical Centre and National Clinical Research Center of Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.
² Geriatric Cardiological Department of the Second Medical Centre and National Clinical Research Center of Geriatric Disease, Chinese People's Liberation Army General Hospital, Beijing, 100853, China.

Abstract

Aim: To study the imaging features of leukoaraiosis (LA) and hemorrhage in cerebral amyloid angiopathy (CAA) patients.

Methods: The earliest MRI images of probable CAA patients and non-CAA patients were collected. The characteristics of LA in the two groups were analyzed. Cerebral micro bleeding (CMB), superficial siderosis (SS), and intracranial hemorrhage (ICH) were recorded in the follow-up study. The space relationship between CMB or SS and ICH was assessed.

Results: We found that 10/21 (47.6%) patients had occipital prominent LA and 14/21 (66.7%) patients had subcortical punctate LA before the ICH, which was higher than that of the ones in the control group (p = 0.015 and 0.038, respectively). The recurrence rate of ICH was 100% (3/3) in patients with diffuse SS and 36.4% (4/11) in patients without. The recurrence rate of ICH was 60% (3/5) in patients with multiple-lobe CMBs and 44.4% (4/9) in those without. The location of the ICH and CMB was inconsistent. ICH occurred in the ipsilateral cerebral hemisphere of SS in three patients with diffuse SS.

Conclusion: LA, diffuse SS, and multiple-lobe CMBs are important imaging characteristics of CAA, which may help make early diagnosis and predict the recurrence of ICH.

Keywords: cerebral amyloid angiopathy; cerebral micro bleeding; intracranial hemorrhage; leukoaraiosis; superficial siderosis; susceptibility weighted imaging.