Implications of quantitative susceptibility mapping at 7 Tesla MRI for microbleeds detection in cerebral small vessel disease

Valentina Perosa; Johanna Rotta; Renat Yakupov; Hugo J Kuijf; Frank Schreiber; Jan T Oltmer; Hendrik Mattern; Hans-Jochen Heinze; Emrah Düzel; Stefanie Schreiber

doi:10.3389/fneur.2023.1112312

Implications of quantitative susceptibility mapping at 7 Tesla MRI for microbleeds detection in cerebral small vessel disease

Front Neurol. 2023 Mar 15:14:1112312. doi: 10.3389/fneur.2023.1112312. eCollection 2023.

Authors

Valentina Perosa¹, Johanna Rotta², Renat Yakupov^{3

4}, Hugo J Kuijf⁵, Frank Schreiber^{2

4}, Jan T Oltmer⁶, Hendrik Mattern^{4

7}, Hans-Jochen Heinze^{2

3

4

8}, Emrah Düzel^{3

4

8

9}, Stefanie Schreiber^{2

4

8}

Affiliations

¹ J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Boston, MA, United States.
² Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany.
³ Institute of Cognitive Neurology and Dementia Research (IKND), Magdeburg, Germany.
⁴ German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany.
⁵ Image Sciences Institute, University Medical Center Utrecht, Utrecht, Netherlands.
⁶ Athinoula A. Martinos Center, Massachusetts General Hospital, Department of Radiology, Boston, MA, United States.
⁷ Institute of Physics, Otto-von-Guericke University, Magdeburg, Germany.
⁸ Center for Behavioral Brain Sciences, Magdeburg, Germany.
⁹ Institute of Cognitive Neuroscience, University College London, London, United Kingdom.

Abstract

Background: Cerebral microbleeds (MBs) are a hallmark of cerebral small vessel disease (CSVD) and can be found on T2^*-weighted sequences on MRI. Quantitative susceptibility mapping (QSM) is a postprocessing method that also enables MBs identification and furthermore allows to differentiate them from calcifications.

Aims: We explored the implications of using QSM at submillimeter resolution for MBs detection in CSVD.

Methods: Both 3 and 7 Tesla (T) MRI were performed in elderly participants without MBs and patients with CSVD. MBs were quantified on T2^*-weighted imaging and QSM. Differences in the number of MBs were assessed, and subjects were classified in CSVD subgroups or controls both on 3T T2^*-weighted imaging and 7T QSM.

Results: 48 participants [mean age (SD) 70.9 (8.8) years, 48% females] were included: 31 were healthy controls, 6 probable cerebral amyloid angiopathy (CAA), 9 mixed CSVD, and 2 were hypertensive arteriopathy [HA] patients. After accounting for the higher number of MBs detected at 7T QSM (Median = Mdn; Mdn_7T-QSM = 2.5; Mdn_3T-T2 = 0; z = 4.90; p < 0.001) and false positive MBs (6.1% calcifications), most healthy controls (80.6%) demonstrated at least one MB and more MBs were discovered in the CSVD group.

Conclusions: Our observations suggest that QSM at submillimeter resolution improves the detection of MBs in the elderly human brain. A higher prevalence of MBs than so far known in healthy elderly was revealed.

Keywords: 7 Tesla MRI; cerebral amyloid angiopathy (CAA); cerebral small vessel disease (CSVD); hypertensive arteriopathy (HA); microbleeds; quantitative susceptibility mapping (QSM).

Grants and funding

This study was supported by the German Research Foundation (DFG) (454245528 to VP and 425899996 to SS and ED, and MA 9235/1-1 to HM). The study has not been supported by any sponsor.