Abstract #0874

Microstructural and microvascular alterations in small vessel diseases using multi-shell DTI inside and outside white matter hyperintensities

Paulien Voorter¹, Maud van Dinther², Michael Stringer³, Danielle Kerkhofs², Anna Dewenter⁴, Gordon Blair³, Daniela Jaime Garcia³, Francesca Chappell³, Anna Kopczak⁴, Julie Staals², Michael Ingrisch⁴, Marco Duering⁴, Michael Thrippleton³, Fergus Doubal³, Martin Dichgans⁴, Joanna Wardlaw³, Robert van Oostenbrugge², Jacobus Jansen¹, and Walter Backes¹

¹Department of Radiology and Nuclear Medicine, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands, ²Department of Neurology, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, Netherlands, ³Brain Research Imaging Centre, Centre for Clinical Brain Sciences, UK Dementia Institute Centre at the University of Edinburgh, Edinburgh, United Kingdom, ⁴Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany

Synopsis

Keywords: Stroke, Stroke, small vessel diseaseThe pathophysiology underlying white matter hyperintensities (WMHs) and changes in perilesional white matter are not fully understood in cerebral small vessel disease (SVD). Using multi-shell diffusion tensor imaging (DTI), we studied the mean (parenchymal) diffusivity (MD) and microvascular perfusion (f) inside and outside WMHs in sporadic and monogenetic (CADASIL) SVDs. The microstructure (expressed by MD) was most damaged inside WMHs and extended beyond the WMHs. Furthermore, f was highest at the WMH border, decreased towards the WMH center, and decreased outside WMHs, possibly reflecting multiple SVD-related alterations in the microvasculature, such as dilated microvessels, capillary rarefaction, and reduced microvascular integrity.

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