Abstract
The goal of this thesis was to elucidate the details of cerebellovascular diseases with advanced magnetic resonance (MR) imaging (MRI) and to translate the findings to routine clinical MRI. The first aim was to image cerebellar arterial perfusion territories, which was achieved by applying super-selective arterial spin labelling (ASL) MRI with labelling of both vertebral arteries in addition to the carotid arteries. The second aim was to unravel the imaging patterns of cerebellar infarctions with 7T post-mortem MRI in addition to volume (3D) clinical MRI. This research led to the description of “cerebellar cortical infarct cavities”, an incidental imaging finding that proved to be the most frequent manifestation of cerebellar ischemia as well as a marker of atherosclerotic and thromboembolic cerebrovascular disease. Finally, we found that almost all patients with such cavities lack a clinical history of vertebrobasilar transient ischemic attack (TIA) or stroke, disclosing the still very high incidence of clinically occult ischemia in the posterior fossa.
Highlights
The goal of this thesis was to elucidate the details of cerebellovascular diseases with advanced magnetic resonance (MR) imaging (MRI) and to translate the findings to routine clinical MRI
The aims of this thesis were to image cerebellar perfusion territories, to precisely describe the imaging patterns of cerebellar infarctions, and to investigate the commonly observed incidental cerebellar cavities on MRI. This pictorial essay gives an illustrated overview of the highlights of this thesis with the objective to increase the diagnostic potential of MRI for cerebellar infarctions in clinical practice
Small cerebellar infarcts are traditionally classified into “watershed” or “border zone” perfusion territories, arterial perfusion territories and the border zones in between them are widely variable among subjects
Summary
The goal of this thesis was to elucidate the details of cerebellovascular diseases with advanced magnetic resonance (MR) imaging (MRI) and to translate the findings to routine clinical MRI. The first aim was to image cerebellar arterial perfusion territories, which was achieved by applying super-selective arterial spin labelling (ASL) MRI with labelling of both vertebral arteries in addition to the carotid arteries. The second aim was to unravel the imaging patterns of cerebellar infarctions with 7T post-mortem MRI in addition to volume (3D) clinical MRI. This research led to the description of “cerebellar cortical infarct cavities”, an incidental imaging finding that proved to be the most frequent manifestation of cerebellar ischemia as well as a marker of atherosclerotic and thromboembolic cerebrovascular disease. We found that almost all patients with such cavities lack a clinical history of vertebrobasilar transient ischemic attack (TIA) or stroke, disclosing the still very high incidence of clinically occult ischemia in the posterior fossa
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