[7 Tesla MRI for visualisation of small cerebral vessels]. / 7-Tesla-MRI voor afbeelden van kleine hersenvaten.

Due to its higher resolution, MRI in which a magnet with a field strength of 7 Tesla (7T MRI) is used, is able to image smaller abnormalities. 7T MRI is a promising tool for research into the causes of cerebral small vessel disease. Originally this technique was aimed at imaging the small perforating brain vessels and in particular at the micro-thrombi present there. Although 7T MRI has not proved effective in showing thrombi in small blood vessels, it has proved itself to be effective on other fronts. Functional measurements of the small brain vessels can be reliably determined and abnormalities of the vessel wall can be imaged. However, the most promising development is the possibility of diagnosing so-called micro-infarctions of the cortex. These extremely small infarctions are an expression of ischaemic damage in degenerating small brain vessels, which for this reason are an important marker of brain ageing.

Cerebral small-vessel disease and progression of brain atrophy: the SMART-MR study.

OBJECTIVES: To investigate whether severity and progression of periventricular and deep white matter lesions (WML) and lacunar infarcts were associated with progression of brain atrophy. METHODS: Within the SMART-MR study, a prospective cohort on MRI changes in patients with symptomatic atherosclerotic disease, 565 patients (57 ± 9 years) without large infarcts had vascular screening and 1.5 T MRI at baseline and after a mean follow-up of 3.9 years. With automated brain segmentation, total brain, cortical gray matter, ventricular, and WML volumes were estimated and expressed relative to intracranial volume (%). Lacunar infarcts were rated manually. RESULTS: Using linear regression analyses adjusted for demographics and vascular risk factors, periventricular WML volume at baseline was associated with greater decrease in cortical gray matter volume (B = -1.73%, 95% confidence interval [CI] -3.15% to -0.30%, per 1% WML volume increase) and greater increase in ventricular volume (B = 0.12%, 95% CI 0.04% to 0.20%). Progression of periventricular WML volume corresponded with a greater decrease in cortical gray matter volume (B = -0.45%, 95% CI -0.9% to 0%) and greater increase in ventricular volume (B = 0.15%, 95% CI 0.1% to 0.2%). Presence of lacunar infarcts was associated with greater decline in total brain volume (B = -0.25%, 95% CI -0.49% to -0.01%) and progression of lacunar infarcts with a greater decrease of total brain (B = -0.30%, 95% CI -0.59% to 0.01%) and cortical gray matter volume (B = -0.81%, 95% CI -1.43% to -0.20%). CONCLUSIONS: In patients with symptomatic atherosclerotic disease, presence and progression of periventricular WML and lacunar infarcts is associated with greater progression of brain atrophy independent of vascular risk factors.

Sclerosing polycystic adenosis: a case report.

About 70 to 80 percent of all salivary gland neoplasms, the majority of which are benign, arise in the parotid gland. Sclerosing Polycystic Adenosis (SPA) is a relatively unknown and newly described entity that is considered to be benign in nature. A 55-year-old patient was treated for SPA in our hospital. The diagnostic work-up consisted of Magnetic Resonance Imaging (MRI), Fine Needle Aspiration Cytology (FNAC) and histological examination. However, in our case, both the cytological appearance, which usually has a high accuracy in discriminating benign from malignant lesions, and the appearance on MR images, mimicked a malignant tumour. This case report illustrates the importance of an adequate histological confirmation of the work-up diagnosis.