Alzheimer's disease (AD) is a prevalent neurodegenerative disease in aged people. The definitive diagnosis of AD is its neuropathology, but clinical practice usually depends on criteria. The currently proposed neuroimages and biomarkers could improve the accuracy of diagnosis, but these applications might be limited. Cerebral amyloid angiopathy (CAA) is a common pathological change in AD but rare in other types of neurodegenerative dementia. CAA could increase the risk of cerebral lobar mass hemorrhage and microhemorrhage. CAA and cerebral microhemorrhages in AD have similar spatial distribution of lobar predominance, and their accumulation similarly affect cognitive function. We suggest there is a strong correlation between CAA intensity and the number of lobar microhemorrhages in AD. In this article, we proposed a hypothesis that has not been studied: by detecting the presence and location pattern of cerebral microhemorrhages with a sensitive technique, high magnetic field susceptibility weighted image (SWI), we may have an alternative way of AD diagnosis as well as dementia differential diagnosis.
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