This Article Full Text Full Text (PDF) All Versions of this Article: 36/11/2384    most recent 01.STR.0000185678.26296.38v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hervé, D. Articles by Chabriat, H. Search for Related Content PubMed PubMed Citation Articles by Hervé, D. Articles by Chabriat, H. Pubmed/NCBI databases Genetics Home Reference Medline Plus Health Information MRI Scans Related Collections Cerebral Lacunes Computerized tomography and Magnetic Resonance Imaging

(Stroke. 2005;36:2384.)
© 2005 American Heart Association, Inc.

Original Contributions

Shape and Volume of Lacunar Infarcts

A 3D MRI Study in Cerebral Autosomal Dominant Arteriopathy With Subcortical Infarcts and Leukoencephalopathy

Dominique Hervé, MD; Jean-François Mangin, PhD; Nicolas Molko, MD, PhD; Marie-Germaine Bousser, MD Hugues Chabriat, MD, PhD

From the Department of Neurology (D.H., M.-G.B., H.C.), CHU Lariboisière, Paris; 2INSERM U562 (J.-F.M., H.C.), Service Hospitalier Frédéric Joliot, Commissariat à l’Energie Atomique, Orsay; and Institut Federatif de Recherche 49 (N.M., H.C.), Service Hospitalier Frédéric Joliot, Commissariat à l’Energie Atomique, Orsay, France.

Correspondence to Hugues Chabriat, MD, PhD, Service de Neurologie, Hôpital, Lariboisière, 3 rue Ambroise Paré, 75010 Paris, France. E-mail hugues.chabriat{at}lrb.ap-hop-paris.fr

Background and Purpose— The shape and exact size of lacunar infarcts have been investigated only postmortem. Recent imaging techniques based on triangulation and connectivity can now be used for 3D segmentation of cerebral lesions. The shape and size of lacunar infarcts was investigated using these techniques in 10 cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) patients.

Methods— We segmented 102 lacunar infarcts on T1-weighted images. The surface of the corresponding set of voxels was computed as a mesh of triangles. Thereafter, the shape of each lesion in 3D was visually analyzed by 2 investigators.

Results— The volume of lesions ranged from 10.5 to 1146 mm, with 93% of them having a volume <500 mm; 83% lacunar infarcts had a spheroid or ovoid shape, but 17% presented as sticks, slabs, or with a complex shape. Lesions with multiple components appeared larger than the others, and a tail extension was noticed in 13 of 102 lesions.

Conclusions— These results suggest the following: (1) most lacunar infarcts in CADASIL have a volume far below one third of that of a sphere of 15 mm in diameter, the upper limit currently used for their identification on 2D imaging; (2) a significant proportion of lacunar infarcts have a shape distinct from the spheroid-ovoid morphology; and (3) lesions with a complex shape may result from the involvement of the largest small arteries, confluence of ischemic lesions, or secondary tissue degeneration. The segmentation of lacunar infarcts appears promising to better understand the pathophysiology of tissue lesions secondary to small vessel diseases.

Key Words: CADASIL syndrome • diagnostic methods • lacunar infarcts • MRI

This article has been cited by other articles:

				J. R. Sims, L. R. Gharai, P. W. Schaefer, M. Vangel, E. S. Rosenthal, M. H. Lev, and L. H. Schwamm ABC/2 for rapid clinical estimate of infarct, perfusion, and mismatch volumes Neurology, June 16, 2009; 72(24): 2104 - 2110. [Abstract] [Full Text] [PDF]

				D. Herve, O. Godin, C. Dufouil, A. Viswanathan, E. Jouvent, C. Pachai, J.-P. Guichard, M.-G. Bousser, M. Dichgans, and H. Chabriat Three-Dimensional MRI Analysis of Individual Volume of Lacunes in CADASIL Stroke, January 1, 2009; 40(1): 124 - 128. [Abstract] [Full Text] [PDF]

				A.G.W. van Norden, W. F. Fick, K. F. de Laat, I. W.M. van Uden, L. J.B. van Oudheusden, I. Tendolkar, M. P. Zwiers, and F. E. de Leeuw Subjective cognitive failures and hippocampal volume in elderly with white matter lesions Neurology, October 7, 2008; 71(15): 1152 - 1159. [Abstract] [Full Text] [PDF]

				A. A. Gouw, W. M. van der Flier, F. Fazekas, E. C.W. van Straaten, L. Pantoni, A. Poggesi, D. Inzitari, T. Erkinjuntti, L. O. Wahlund, G. Waldemar, et al. Progression of White Matter Hyperintensities and Incidence of New Lacunes Over a 3-Year Period: The Leukoaraiosis and Disability Study Stroke, May 1, 2008; 39(5): 1414 - 1420. [Abstract] [Full Text] [PDF]

				A. Viswanathan, A. Gschwendtner, J. -P. Guichard, F. Buffon, R. Cumurciuc, M. O'Sullivan, M. Holtmannspotter, C. Pachai, M. -G. Bousser, M. Dichgans, et al. Lacunar lesions are independently associated with disability and cognitive impairment in CADASIL Neurology, July 10, 2007; 69(2): 172 - 179. [Abstract] [Full Text] [PDF]

				E. Jouvent, A. Viswanathan, J.-F. Mangin, M. O'Sullivan, J.-P. Guichard, A. Gschwendtner, R. Cumurciuc, F. Buffon, N. Peters, C. Pachai, et al. Brain Atrophy Is Related to Lacunar Lesions and Tissue Microstructural Changes in CADASIL Stroke, June 1, 2007; 38(6): 1786 - 1790. [Abstract] [Full Text] [PDF]

				S. Warach and J. Wardlaw Advances in Imaging 2005 Stroke, February 1, 2006; 37(2): 297 - 298. [Full Text] [PDF]