| ObjectiveTo detect the number and distribution of cerebral microbleeds and analyze the link between clinical data.lacunar imfarction and white matter degeneration via susceptibility weighted imaging (SWI) on MRI aimed to in patients with suspicious cerebrovascular. Reweal the risk factors and the relationship between cerebrovascular disease of the CMBs.To evaluate the clinic value of cerebrovasccular in Susceptibility weighted imaging (SWI) in the detection of cerebral microbleeds.Materials and MethodsTo collect 172 patients of suspicious cerebrovascular examined in Shandong medical imaging institute in the period of December,2009 to February,2011. The patient with hemorrhagic transformation of an ischaemic stroke, intracranial neoplasma, moya disease and vessel malformation were excluded. Informed consent was obtained from each patient for the use of their clinical and imaging data include basic disease,history of hypertension and diabetes, anticoagulant,smoking, alcohol drinking and family history of the aforementioned diagnoses.Every patient's current blood pressure (systolic and diastolic blood pressure) was taken before MR examination. CMBs were described ellipsoid areas of signal abnormality with a diameter of 2–5 mm without peripheral edema based on SWI sequences.And the exclusion of hemorrhage,blood streaming video space,vascular space and brain calcification.And according to the number of CMBs to divided into grade 0-4,grade 0(null),grade 1(1 to3),grade 2(4 to 6),grade 3(7 to 9),grade 4(more than 9).Hypertension is defined assustained systolic blood pressure greater than 140 mmHg, diastolic blood pressure greater than 90 mmHg or ongoing antihypertensive treatment clinical needs.All the hypertension were dssential hypertension.Blood pressure was taken before MR examination in patients with hypertension and was graded in accordance with the WHO international classification. Normal blood pressure (grade 0)was as follows: systolic blood pressure <140mmHg; diastolic blood pressure <90 mmHg; grade 1: systolic blood pressure 140–159 mmHg; diastolic blood pressure 90–99 mmHg; grade 2: systolic blood pressure 160–179 mmHg, diastolic blood pressure 100–109 mmHg; grade 3: systolic blood pressure≥180 mmHg, diastolic blood pressure≥110 mmHg. There are 98 males and 74 females, the age ranged from 35 to 82 ,125 patients with hypertension and 71 patients with CMBs.Lacunar infaction were described ellipsoid areas of long T1WI,long T2WI equal,high or immingle T2FLAIR signal abnormality with a diameter of less than 20mm .And the exclusion vessel around space or spot of white matter denaturalization .And according to the number of CMBs to divided into grade 0-3,where 38 cases of grade 0 ,50 cases of grade 1,34 cases of grade 2,50 cases of grade 3.White matter changes according to Aharon-Peretz reference standards of CT to divided into 0-4.where 49 cases of normal blood pressure ,82 cases of grade 1,19 cases of grade 2,13 cases of grade 3,9 cases of grade 4.Diagnostic criteria for diabetes according to 1999 WHO established diagnostic cteteria for diabetes.All patients examined by GE SIGNA EXCITE HDs 3.0T MR scanner,use 8 channels headcoil.All examined obtained routine transect and arrowsect,and sequence of T1Flair,T2WI,T2Flair and SWI.The original data transmit to GE AW4.3 workstation and deal with Functool.Then obtained SWI map.Last reconstruct by minp. All data were analyzed using SPSS 13.0 statistical software. The measurement data between groups was analyzed by t test, CMBs grading and the classification of hypertension, CMBs grading and the severity of lacunar infaction and white matter change by Spearman correlated tests. CMBs risk factors were analyzed and evaluated by logistic regression.The P<0.05 as the criteria of difference was statisticallysignificant.Results1.All cases obtained satisfied SWI map according to clinical.The CMBs can be clearly and exactly displayed.2.There were significant differences in age,gender,hypertension status, patient's current blood pressure(systolic and diastolic blood pressure), lacunar infarction and white matter change between the two groups. And there were no statistics differences in history of diabetes, anticoagulant, smoking, alcohol drinkingbetween the two groups.3.There was a significant statistics differences in systolic blood pressure between the CMBs groups have or have not hypertension. There was a significantly correlation between CMBs distribute character and hypertension:the CMBs with normal blood pressure mostly discovered in cortical-subcortical (CSC), abasal ganglionic region,while the CMBs with hypertension mostly discovered in deep region include fundus and thalamencephalon.Otherwise, there was a significantly correlation between CMBs. With higher grades of hypertension,CMBs showed an upward trend in number.4.Most CMBs patients occurred with lacunar infarction,and there was a significantly correlation between the two grade levels. With higher grades of lacunar infarction,CMBs showed an upward trend in number.5.Generally ,CMBs patients occurred with white matter changes, there was a significantly correlation between the two grade levels.6.The number and distribution of CMBs indirectly reflects the extent and causes of the cerebral microvascular injury.7.CMBs is the prediction signal of occurrence of stroke,cerebral hemorrhage and other cerebrovascular disease prediction.It is also an important index the application of anticoagulant and thrombolytic therapy.ConclusionsCMBs can be clearly displayed on the SWI,hypertension is a major risk factor of the CMBs. The number and distribution of CMBs indirectly reflects the extent and causes of the cerebral microvascular injury.It is the prediction signal of occurrence of stroke,cerebral hemorrhage and other cerebrovascular disease prediction.It is also an important index the application of anticoagulant and thrombolytic therapy.The detection of CMBs in SWI has important clinical value in prevention and treatment of cerebrovasccular includes stroke and cerebral hemorrhage. |
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