Can novel CT-and MR-based neuroimaging biomarkers further improve the etiological diagnosis of lobar intra-cerebral hemorrhage?

Jensen‐Kondering, Ulf; Sacco, Simona; Posener, Sacha; Benzakoun, Joseph; Pallud, Johan; Oppenheim, Catherine; Varlet, Pascale; Turc, Guillaume

doi:10.1007/s00415-022-11434-y

Cited by 3 publications

(1 citation statement)

References 56 publications

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“…However, survivors of cerebral hemorrhage are often accompanied by many neurological sequelae that impair quality of life. In clinical treatment, it is necessary to distinguish ICH subtypes in patients with ICH, as the risk of recurrence of cerebral amyloid angiopathy (CAA)-related ICH is approximately 7% per year [ 5 ], and the risk of recurrence of non-CAA-related ICH is significantly lower. Moreover, the differentiation of cerebral hemorrhage subtypes is also meaningful for later clinical decision-making.…”

Section: Introductionmentioning

confidence: 99%

Deep Medullary Vein and MRI Markers Were Related to Cerebral Hemorrhage Subtypes

Wang,

Xiang,

Peng

et al. 2023

Brain Sciences

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Background: To explore the performance of deep medullary vein (DMV) and magnetic resonance imaging (MRI) markers in different intracerebral hemorrhage (ICH) subtypes in patients with cerebral small vessel disease (CSVD). Methods: In total, 232 cases of CSVD with ICH were included in this study. The clinical and image data were retrospectively analyzed. Patients were divided into hypertensive arteriopathy (HTNA)-related ICH, cerebral amyloid angiopathy (CAA)-related ICH, and mixed ICH groups. The DMV score was determined in the cerebral hemisphere contralateral to the ICH. Results: The DMV score was different between the HTNA-related and mixed ICH groups (p < 0.01). The MRI markers and CSVD burden score were significant among the ICH groups (p < 0.05). Compared to mixed ICH, HTNA-related ICH diagnosis was associated with higher deep white matter hyperintensity (DWMH) (OR: 0.452, 95% CI: 0.253–0.809, p < 0.05) and high-degree perivascular space (PVS) (OR: 0.633, 95% CI: 0.416–0.963, p < 0.05), and CAA-related ICH diagnosis was associated with increased age (OR: 1.074; 95% CI: 1.028–1.122, p = 0.001). The DMV score correlated with cerebral microbleed (CMB), PVS, DWMH, periventricular white matter hyperintensity (PWMH), and CSVD burden score (p < 0.05) but not with lacuna (p > 0.05). Age was an independent risk factor for the severity of DMV score (OR: 1.052; 95% CI: 0.026–0.076, p < 0.001). Conclusion: DMV scores, CSVD markers, and CSVD burden scores were associated with different subtypes of ICH. In addition, DMV scores were associated with the severity of CSVD and CSVD markers.

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Section: Introductionmentioning

confidence: 99%

Deep Medullary Vein and MRI Markers Were Related to Cerebral Hemorrhage Subtypes

Wang,

Xiang,

Peng

et al. 2023

Brain Sciences

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Association ofAPOEgenotype with CT markers of cerebral amyloid angiopathy in spontaneous intracerebral haemorrhage

Yang,

Zeng,

Tang

et al. 2024

Stroke Vasc Neurol

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Background and objectiveWe investigated the association ofAPOEalleles with CT-based cerebral amyloid angiopathy (CAA) markers including subarachnoid extension (SAE) and finger-like projection (FLP).MethodsWe included patients with acute primary supratentorial intracerebral haemorrhage (ICH) from a multicentre cohort in China. First, the association ofAPOEwith ICH location (lobar vs non-lobar) was evaluated. Next, the relationships ofAPOEwith SAE, FLP, and the coexistence of the two (SAE+FLP) were evaluated.Results533 patients with supratentorial ICH were enrolled. Among them were 138 patients with lobar ICH and 395 with non-lobar ICH. Compared with the non-lobar group,APOEε4 (OR 1.894, 95% CI 1.138 to 3.154, p=0.014) and ε2/ε4 (OR 6.098, 95% CI 1.414 to 26.293, p=0.015) were associated with lobar ICH. With regard to CAA markers,APOEε2 was associated with SAE (OR 2.109, 95% CI 1.167 to 3.810, p=0.013), ε4 was associated with FLP and SAE+FLP (OR 3.026, 95% CI 1.353 to 6.767, p=0.007; OR 3.514, 95% CI 1.485 to 8.316, p=0.004, respectively) and ε2/ε4 was associated with all three factors (SAH: OR 7.599, 95% CI 1.764 to 32.734, p=0.006; FLP: OR 20.333, 95% CI 3.278 to 126.137, p=0.001; SAE+FLP: OR 30.568, 95% CI 4.460 to 209.503, p<0.001) after adjusting for age, and remained significant after adjusting for age and ICH volume.ConclusionIn patients with spontaneous supratentorial ICH,APOEε2 and ε4 alleles were associated with SAE and FLP, respectively, suggestingAPOEallele-specific effects on CT markers of CAA and their potential mechanisms.

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Neuroradiological Findings in Cerebral Amyloid Angiopathy with a Particular Consideration of the Boston Criteria 2.0: An Imaging Review

Jensen-Kondering,

Heß,

Neumann

et al. 2024

Biomolecules

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In the elderly, cerebral amyloid angiopathy (CAA) is the most common cause for intracranial lobar hemorrhages. CAA is caused by the accumulation of amyloid-β fibrils in cortical and leptomeningeal vessels. In 2022, the Boston Criteria 2.0 became the new diagnostic standard for CAA, following the Modified Boston Criteria of 2010. The diagnostic criteria are a composite of clinical, imaging and histopathological findings. In the latest version of the Boston Criteria, neuroradiological imaging findings were even expanded compared to the previous version. Crucially, the correct application of the diagnostic criteria is necessary to avoid over- and underdiagnosis. The aim of this review is to demonstrate the diagnostic criteria for CAA with an emphasis on typical imaging findings which are part of the Boston Criteria 2.0 and other imaging findings suggestive of CAA.

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Can novel CT-and MR-based neuroimaging biomarkers further improve the etiological diagnosis of lobar intra-cerebral hemorrhage?

Cited by 3 publications

References 56 publications

Deep Medullary Vein and MRI Markers Were Related to Cerebral Hemorrhage Subtypes

Deep Medullary Vein and MRI Markers Were Related to Cerebral Hemorrhage Subtypes

Association ofAPOEgenotype with CT markers of cerebral amyloid angiopathy in spontaneous intracerebral haemorrhage

Neuroradiological Findings in Cerebral Amyloid Angiopathy with a Particular Consideration of the Boston Criteria 2.0: An Imaging Review

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