Ty Shang, Peter V Sguigna, Marco C Pinho, William Moore, Erica Jones, Suriya Subramanian, Parth Upadhyaya, Brendan Kelley, Kimmo J Hatanpaa, Jack Raisanen
{"title":"Microenhancement as a Biomarker for Cerebral Microbleed in Inflammatory Cerebral Amyloid Angiopathy: Insights From 3D T1 Black-Blood MR Imaging.","authors":"Ty Shang, Peter V Sguigna, Marco C Pinho, William Moore, Erica Jones, Suriya Subramanian, Parth Upadhyaya, Brendan Kelley, Kimmo J Hatanpaa, Jack Raisanen","doi":"10.1212/WNL.0000000000210258","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>Cerebral microbleeds (cMBs) are common imaging findings in conditions related to cerebral amyloid angiopathy (CAA). Blood-brain barrier (BBB) leakage is considered pivotal in their pathogenesis. This study investigates the potential role of cerebral microenhancement (cME) as an imaging biomarker on 3D T1 black-blood MRI (BB-MRI) for BBB rupture, predicting the formation of cMBs in inflammatory CAA variants.</p><p><strong>Methods: </strong>A retrospective review was conducted on biopsy-confirmed cases of CAA-related inflammation (CAA-ri) and amyloid-beta-related angiitis (ABRA) from the UT Southwestern Medical Center's BB-MRI registry (2014-2022). Subjects underwent 3D T1 BB MRI and susceptibility-weighted imaging. The presence and progression of cMEs and cMBs were assessed.</p><p><strong>Results: </strong>A total of 5 subjects (1 CAA-ri, 4 ABRA) were identified. Frequent cMEs on 3D T1 BB MRI scans preceded cMB formation, particularly in subjects with the <i>ApoE</i> ɛ4/4 genotype experiencing a refractory clinical course. Stable subjects had fewer cMEs and cMBs.</p><p><strong>Discussion: </strong>The presence of cME before cMB suggests their potential as a biomarker for cMB formation. The findings align with the hypothesis that BBB rupture and focal inflammation are critical in cMB pathogenesis. Further validation of 3D T1 BB MRI as an assessment tool for cMB formation in inflammatory CAA based on clinicoradiologic diagnosis and noninflammatory CAA could enhance monitoring and treatment strategies.</p>","PeriodicalId":19256,"journal":{"name":"Neurology","volume":"104 2","pages":"e210258"},"PeriodicalIF":7.7000,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1212/WNL.0000000000210258","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/2 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Microenhancement as a Biomarker for Cerebral Microbleed in Inflammatory Cerebral Amyloid Angiopathy: Insights From 3D T1 Black-Blood MR Imaging.
Objectives: Cerebral microbleeds (cMBs) are common imaging findings in conditions related to cerebral amyloid angiopathy (CAA). Blood-brain barrier (BBB) leakage is considered pivotal in their pathogenesis. This study investigates the potential role of cerebral microenhancement (cME) as an imaging biomarker on 3D T1 black-blood MRI (BB-MRI) for BBB rupture, predicting the formation of cMBs in inflammatory CAA variants.
Methods: A retrospective review was conducted on biopsy-confirmed cases of CAA-related inflammation (CAA-ri) and amyloid-beta-related angiitis (ABRA) from the UT Southwestern Medical Center's BB-MRI registry (2014-2022). Subjects underwent 3D T1 BB MRI and susceptibility-weighted imaging. The presence and progression of cMEs and cMBs were assessed.
Results: A total of 5 subjects (1 CAA-ri, 4 ABRA) were identified. Frequent cMEs on 3D T1 BB MRI scans preceded cMB formation, particularly in subjects with the ApoE ɛ4/4 genotype experiencing a refractory clinical course. Stable subjects had fewer cMEs and cMBs.
Discussion: The presence of cME before cMB suggests their potential as a biomarker for cMB formation. The findings align with the hypothesis that BBB rupture and focal inflammation are critical in cMB pathogenesis. Further validation of 3D T1 BB MRI as an assessment tool for cMB formation in inflammatory CAA based on clinicoradiologic diagnosis and noninflammatory CAA could enhance monitoring and treatment strategies.
期刊介绍：
Neurology, the official journal of the American Academy of Neurology, aspires to be the premier peer-reviewed journal for clinical neurology research. Its mission is to publish exceptional peer-reviewed original research articles, editorials, and reviews to improve patient care, education, clinical research, and professionalism in neurology.
As the leading clinical neurology journal worldwide, Neurology targets physicians specializing in nervous system diseases and conditions. It aims to advance the field by presenting new basic and clinical research that influences neurological practice. The journal is a leading source of cutting-edge, peer-reviewed information for the neurology community worldwide. Editorial content includes Research, Clinical/Scientific Notes, Views, Historical Neurology, NeuroImages, Humanities, Letters, and position papers from the American Academy of Neurology. The online version is considered the definitive version, encompassing all available content.
Neurology is indexed in prestigious databases such as MEDLINE/PubMed, Embase, Scopus, Biological Abstracts®, PsycINFO®, Current Contents®, Web of Science®, CrossRef, and Google Scholar.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
