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This study reveals a high prevalence of incidental diffusion-weighted imaging (DWI)-positive lesions in patients with cerebral amyloid angiopathy (CAA) and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL). These lesions exhibit distinct spatial patterns aligned with each disease’s pathophysiology and correlate with neurodegenerative biomarkers such as serum and cerebrospinal fluid neurofilament light chain (NfL). The research positions incidental DWI-positive lesions as important markers of cerebral small vessel disease (SVD), warranting further exploration of their prognostic implications.
