Ultra-high-field 7T MRI reveals venous-dominant cerebral microbleeds in CAA compared to 3T

7T MRI more than doubles venous cerebral microbleed (vCMB) detection in CAA vs 3T (1173 vs 385), with higher vCMB ratio (0.70 vs 0.33). But weak cross-scanner correlation (r=0.32) precludes interchangeability; 7T may better detect small lesions.

• Single-center retrospective study of 22 patients with probable CAA underwent paired 3T and 7T MRI within 6 months.
• 7T detected more total CMB (1551 vs 818) and vCMB (1173 vs 385), but simple/non-venous CMB did not differ significantly (p=0.47); median vCMB-to-total ratio was higher at 7T (0.70 vs 0.33, p<0.001).
• Lesion-level comparisons were descriptive only due to within-subject clustering, limiting per-lesion validation; inter-scanner correlation for the vCMB-to-total ratio was weak (r=0.32, p=0.16).

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