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Vascular dementia

I had an Mri without contrast and it said for impression

Possible small vessel ischemic disease

I'm going to a neurologist now and they are having me do a Mri with contrast of brain and brain stem.  What would the Mri with contrast do.  I mean will it confirm or not confirm small vessel ischemic disease?  I do have multiple lesions.  
My symptoms are memory loss,leg weakness, problem talking sometimes, I get lost going to places I have been dozens of times.  Balance problems,  irritable, sometimes hallucinations or delusions not sure the difference.
I do have high cholesterol high triglycerides and low HDL
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