Reproducibility and variability of quantitative magnetic resonance imaging markers in cerebral small vessel disease

Francois De Guio, Eric Jouvent, Geert Jan Biessels, Sandra E. Black, Carol Brayne, Christopher Chen, Charlotte Cordonnier, Frank-Eric De Leeuw, Martin Dichgans, Fergus Doubal, Marco Duering, Carole Dufouil, Emrah Duzel, Franz Fazekas, Vladimir Hachinski, M. Arfan Ikram, Jennifer Linn, Paul M. Matthews, Bernard Mazoyer, Vincent MokBo Norrving, John T. O'Brien, Leonardo Pantoni, Stefan Ropele, Perminder Sachdev, Reinhold Schmidt, Sudha Seshadri, Eric E. Smith, Luciano A. Sposato, Blossom Stephan, Richard H. Swartz, Christophe Tzourio, Mark van Buchem, Aad van der Lugt, Robert van Oostenbrugge, Meike W. Vernooij, Anand Viswanathan, David Werring, Frank Wollenweber, Joanna M. Wardlaw, Hugues Chabriat*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

64 Citations (Web of Science)


Brain imaging is essential for the diagnosis and characterization of cerebral small vessel disease. Several magnetic resonance imaging markers have therefore emerged, providing new information on the diagnosis, progression, and mechanisms of small vessel disease. Yet, the reproducibility of these small vessel disease markers has received little attention despite being widely used in cross-sectional and longitudinal studies. This review focuses on the main small vessel disease-related markers on magnetic resonance imaging including: white matter hyperintensities, lacunes, dilated perivascular spaces, microbleeds, and brain volume. The aim is to summarize, for each marker, what is currently known about: (1) its reproducibility in studies with a scan-rescan procedure either in single or multicenter settings; (2) the acquisition-related sources of variability; and, (3) the techniques used to minimize this variability. Based on the results, we discuss technical and other challenges that need to be overcome in order for these markers to be reliably used as outcome measures in future clinical trials. We also highlight the key points that need to be considered when designing multicenter magnetic resonance imaging studies of small vessel disease.
Original languageEnglish
Pages (from-to)1319-1337
JournalJournal of Cerebral Blood Flow and Metabolism
Issue number8
Publication statusPublished - Aug 2016


  • Magnetic resonance imaging
  • cerebral small vessel disease
  • marker
  • brain volume
  • atrophy
  • white matter hyperintensities
  • microbleeds
  • lacunes
  • perivascular spaces
  • reproducibility
  • repeatability
  • variability

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