Susceptibility-weighted imaging reveals cerebral microvascular injury in severe COVID-19

被引：49

作者：

Conklin, John ^{[1
,2
,3
]}

Frosch, Matthew P. ^{[2
,5
,7
]}

Mukerji, Shibani S. ^{[2
,7
]}

Rapalino, Otto ^{[1
,2
]}

Maher, Mary D. ^{[1
,2
]}

Schaefer, Pamela W. ^{[1
,2
]}

Lev, Michael H. ^{[1
,2
]}

Gonzalez, R. G. ^{[1
,2
]}

Das, Sudeshna ^{[2
,7
]}

Champion, Samantha N. ^{[5
]}

Magdamo, Colin ^{[2
,7
]}

Sen, Pritha ^{[2
,6
]}

Harrold, G. Kyle ^{[2
,7
]}

Alabsi, Haitham ^{[2
,7
]}

Normandin, Erica ^{[8
,9
]}

Shaw, Bennett ^{[2
,6
,8
,9
]}

Lemieux, Jacob E. ^{[2
,6
]}

Sabeti, Pardis C. ^{[8
,9
]}

Branda, John A. ^{[2
,11
]}

Brown, Emery N. ^{[2
,10
]}

Westover, M. Brandon ^{[2
,7
]}

Huang, Susie Y. ^{[1
,2
,3
]}

Edlow, Brian L. ^{[2
,3
,4
,7
]}

机构：

[1] Massachusetts Gen Hosp, Dept Radiol, Boston, MA 02114 USA

[2] Harvard Med Sch, Boston, MA 02115 USA

[3] Massachusetts Gen Hosp, Athinoula A Martinos Ctr Biomed Imaging, Charlestown, MA USA

[4] Massachusetts Gen Hosp, Ctr Neurotechnol & Neurorecovery, Boston, MA 02114 USA

[5] Massachusetts Gen Hosp, CS Kubik Lab Neuropathol, Boston, MA 02114 USA

[6] Massachusetts Gen Hosp, Div Infect Dis, Boston, MA 02114 USA

[7] Massachusetts Gen Hosp, Dept Neurol, Boston, MA 02114 USA

[8] MIT, Broad Inst, 77 Massachusetts Ave, Cambridge, MA 02139 USA

[9] Harvard Univ, Cambridge, MA 02138 USA

[10] Massachusetts Gen Hosp, Dept Anesthesia Crit Care & Pain Med, Boston, MA 02114 USA

[11] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA

来源：

JOURNAL OF THE NEUROLOGICAL SCIENCES | 2021年 / 421卷

关键词：

COVID-19; MRI; Susceptibility-weighted imaging; Coma;

D O I：

10.1016/j.jns.2021.117308

中图分类号：

R74 [神经病学与精神病学];

学科分类号：

摘要：

We evaluated the incidence, distribution, and histopathologic correlates of microvascular brain lesions in patients with severe COVID-19. Sixteen consecutive patients admitted to the intensive care unit with severe COVID19 undergoing brain MRI for evaluation of coma or neurologic deficits were retrospectively identified. Eleven patients had punctate susceptibility-weighted imaging (SWI) lesions in the subcortical and deep white matter, eight patients had >10 SWI lesions, and four patients had lesions involving the corpus callosum. The distribution of SWI lesions was similar to that seen in patients with hypoxic respiratory failure, sepsis, and disseminated intravascular coagulation. Brain autopsy in one patient revealed that SWI lesions corresponded to widespread microvascular injury, characterized by perivascular and parenchymal petechial hemorrhages and microscopic ischemic lesions. Collectively, these radiologic and histopathologic findings add to growing evidence that patients with severe COVID-19 are at risk for multifocal microvascular hemorrhagic and ischemic lesions in the subcortical and deep white matter.

引用

页数：5

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