Rofo 2009; 181 - A1
DOI: 10.1055/s-0028-1124032

Therapy optimization in vascular dementia with the help of 7 Tesla?

JM Theysohn 1, 2, O Kraff 1, 2, S Maderwald 1, 2, M Barth 1, 3, C Mönninghoff 1, 2, SC Ladd 1, 2, L Schaefer 1, 2, S Lohbeck 1, 2, M Forsting 1, 2, ME Ladd 1, 2, ER Gizewski 1, 2
  • 1Erwin L. Hahn Institute for Magnetic Resonance Imaging, Essen/Germany
  • 2Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen/Germany
  • 3FC Donders Centre for Cognitive Neuroimaging, Nijmegen/The Netherlands

Purpose: Small vessel disease as seen in hypertension and diabetes can be associated with cerebral microbleeds. These might be indicative of higher risk for future intracerebral hemorrhage. The implementation of susceptibility weighted imaging (SWI) in high field MRI systems (7 Tesla) makes use of enhanced tissue signal and sensitivity to susceptibility differences. Our goal is to present initial results visualizing cerebral hemosiderin deposits and surrounding microangiopathy with high-field MRI.

Materials and Methods: Five healthy volunteers and eight patients with known microbleeds and/or microangiopathy were examined with a whole-body 7 Tesla scanner (Magnetom 7T, Siemens), and an eight-channel transmit-receive head coil (Rapid Biomedical, Germany). Optimized SWI, T2*, and FLAIR sequences at 7 Tesla were compared to standard 1.5 Tesla images regarding depiction of hemosiderin deposits (T2*, SWI) and white matter lesions (FLAIR).

Results: All known pathologies (from 1.5T) were revealed at 7 Tesla. 7T gradient echo sequences (SWI and T2*) revealed especially small microbleeds more clearly in 6/8 patients. 7T-SWI revealed hemosiderin deposits more distinctively than 7T-T2* in 4/8 patients. 7T FLAIR sharply visualized white matter lesions equivalent to 1.5T. Compared to 1.5T, image resolutions were higher at 7T (max. resolution used for SWI: 0.22×0.22×1.5mm3).

Conclusion: 7T MRI can demonstrate signs of cerebral small vessel pathology. Improved detection of microbleeds at 7T might in the future have significant impact on the therapy of patients showing cerebral small vessel disease by providing additional criteria to optimize antithrombotic treatment.