Multifocal low-signal brain lesions on T2 * -weighted gradient-echo imaging

Abstract

Multifocal small low-signal lesions on T2*-weighted gradient-echo (GE) MRI are reported to be common in the brain of hypertensive patients. We examined factors associated with these lesions. For one year, we routinely obtained T2*-weighted GE images (TR 1000 TE 30 ms, flip angle = 20 degrees) in all adult patients (314) who underwent brain MRI in our hospital, using a 1.5 T superconducting magnet. Patients with multifocal small low-signal lesions with a known or presumed pathogenesis or any condition which may cause intracerebral haemorrhage, such as brain tumours, were excluded from further analysis. Thus, 191 cases remained (104 men and 87 women; age, 62.8+/-11.0 years, range, 30-89 years). The overall prevalence of multifocal small low-signal lesions on the GE images was 15.2% (29/191); they were commonly in the cerebral white matter and basal ganglia. They were detected in 12 (52.2%) of the 23 patients with prior symptomatic brain hemorrhage, 12 (20.7%) of the 58 with prior symptomatic infarcts, and only five (4.5%) of 110 without a prior stroke. Logistic regression analysis indicated that multifocal small low-signal lesions were significantly correlated with a symptomatic acute brain haemorrhage (odds ratio, 13.17), chronic hypertension (4.00) and a symptomatic acute infarct (3.71). The association with symptomatic acute brain haemorrhage suggests that this finding may represent subclinical microhaemorrhage. The diagnostic potential of this finding to identify individuals at risk of symptomatic intracerebral haemorrhage may require further investigation.

Magnetic Resonance Imaging Detection of Microbleeds Before Thrombolysis

“…5,[13][14][15][16][17] In their study of patients with a history of atherosclerosis, Kwa et al 5 found that hemosiderin deposits visualized with MRI were significantly associated with cerebral white matter lesions.…”

Hematoma talámico bilateral simultáneo: Reporte de dos casos y revisión de la literatura

“…Existe un incremento en la incidencia de MH dependiendo del grupo de pacientes seleccionado. Así, se reporta una incidencia en individuos neurológicamente asintomáticos de un 6,4%, la mayoría hipertensos, mayores de 65 años, con MH ubicadas principalmente en ganglios basales y tálamo, asociadas a lesiones isquémicas lacunares antiguas y leucoariosis (27) ; un 10% en pacientes con infarto al miocardio (28) ; un 21% a 47% en pacientes con (ECV) isquémico no seleccionado (26,29) ; un 46% a 62% en pacientes con infarto lacunar agudo, que aumenta a un 68% cuando son múltiples (29,31) y un 50% a 80% en pacientes con HE primaria (32)(33)(34)(35)(36) . Recientemente se ha descrito la presencia de MH en la angiopatía cerebral B-amiloidea, ubicadas en la región córtico-subcortical, que se asocian fuertemente a HE e incluso pueden precederla (37)(38)(39)(40) .…”

High Incidence of Microbleeds in Hemodialysis Patients Detected by T2*-Weighted Gradient-Echo Magnetic Resonance Imaging

“…HD patients have many risk factors for hemorrhagic stroke, such as hypertension, systemic heparinization, ultrafiltration to treat fluid accumulation, poor platelet adhesion, and infection. 23) Previous studies have shown a positive correlation between microbleeds and hypertension, 25,26,28) but the possible causative factor for microbleeds in HD patients has not been identified. In our study, the incidence of hypertension was significantly higher in the HD patients than in the controls.…”

“…12,[14][15][16]20,21,28) T 2 *-weighted gradient-echo magnetic resonance (MR) imaging detected microbleeds in more than 50% of patients with intracerebral hemorrhage. 25,27) The number of microbleeds may be correlated with intracerebral hemorrhage.…”