Assessment of microvascular rarefaction in human brain disorders using physiological magnetic resonance imaging

• Published in: Journal of Cerebral Blood Flow & Metabolism Vol. 42; no. 5; pp. 718 - 737
• Main Authors: van Dinther, Maud, Voorter, Paulien HM, Jansen, Jacobus FA, Jones, Elizabeth AV, van Oostenbrugge, Robert J, Staals, Julie, Backes, Walter H
• Format: Book Review Journal Article
• Language: English
• Published: London, England SAGE Publications 01.05.2022
• Subjects: Blood-Brain Barrier - metabolism; Brain - blood supply; Brain - diagnostic imaging; Brain Diseases - pathology; Humans; Magnetic Resonance Imaging; Microvascular Rarefaction; Review; cerebral small vessel disease; magnetic resonance imaging; Alzheimer’s disease; microvascular density; microvascular rarefaction
• ISSN: 0271-678X; 1559-7016
• DOI: 10.1177/0271678X221076557

Cerebral microvascular rarefaction, the reduction in number of functional or structural small blood vessels in the brain, is thought to play an important role in the early stages of microvascular related brain disorders. A better understanding of its underlying pathophysiological mechanisms, and methods to measure microvascular density in the human brain are needed to develop biomarkers for early diagnosis and to identify targets for disease modifying treatments. Therefore, we provide an overview of the assumed main pathophysiological processes underlying cerebral microvascular rarefaction and the evidence for rarefaction in several microvascular related brain disorders. A number of advanced physiological MRI techniques can be used to measure the pathological alterations associated with microvascular rarefaction. Although more research is needed to explore and validate these MRI techniques in microvascular rarefaction in brain disorders, they provide a set of promising future tools to assess various features relevant for rarefaction, such as cerebral blood flow and volume, vessel density and radius and blood-brain barrier leakage.