Clinical characteristics in normal healthy adults with microbleeds on echo-planar gradient-echo T2*-weighted MRI

DOI 2 Citations 16 References
  • Takahashi Wakoh
    HIMEDIC Imaging Center at Lake Yamanaka Department of Neurology, Tokai University School of Medicine
  • Ohnuki Tomohide
    Department of Neurology, Tokai University School of Medicine
  • Ide Michiru
    HIMEDIC Imaging Center at Lake Yamanaka
  • Takagi Shigcharu
    Department of Neurology, Tokai University School of Medicine
  • Shinohara Yukito
    Department of Neurology, Tokai University School of Medicine Stroke and Neurological Center, Tokai University Tokyo Hospital

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  • 無症候性脳内微小出血陽性例の臨床的特徴

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The gradient-echo T2*-weighted sequence in magnetic resonance imaging is known to be useful for detecting microbleeds (MBs) in patients with intracranial hemorrhage or lacunar stroke. We investigated the characteristics of apparently healthy adults with MBs but without stroke, employing echo-planar gradient-echo T2*-weighted MRI. The subjects were recruited from among 3, 537 participants who underwent brain check-ups at the HIMEDIC Imaging Center. Of the 3, 537 participants, 3, 296 (mean age, 55±11 years) without any history of cerebrovascular disease or apparent focal neurological manifestations were selected for the present study. MBs on echo-planar gradient-echo T2-weighted MRI were observed in 74 (2.2%) of the 3, 296 subjects. Of a total of 133 lesions found in these 74 persons, 31 were located in the basal ganglia or corticosubcortical regions. Thirty were in the deep white matter, 19 in the thalamus, 16 in the cerebellum, and 6 in the brain stem. The subjects with MBs were significantly older than the subjects without MBs, and the mean values for their systolic and diastolic blood pressures were higher than those in the subjects without MBs. Asymptomatic cerebral infarction, periventricular hyperintensity, and deep and subcortical white matter hpyerintensity on T1-and T2-weighted MRI were more frequent in the subjects with MBs, as compared with those without MBs. Asymptomatic cerebral infarction, periventricular hyperintensity, and deep and subcortical white matter hpyerintensity on T1-and T2-weighted MRI were more frequent in the subjects with MBs of the basal ganglia or thalamus than in those with MBs in other regions. MBs on echo-planar gradient-echo T2*-weighted MRI were thus relatively rare in apparently healthy adults. However, MBs in the basal ganglia or thalamus are suggested to be closely related to intracerebral microangiopathy. Persons with MBs in such regions should therefore be carefully checked for cerebrovascular risk factors, especially hypertension.

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