Susceptibility-weighted Imaging In Detection Of Cerebral Microbleeds In Patients With Hypertension At3Tesla MRI

Objective To detect microbleeds in patients with hypertension by susceptibility weighted imaging (SWI), diffusion weighted imaging (DWI) and conventional sequence. To explore incidence and predilection site of CMBs, its correlation with risk factors of cardiovascular disease.Methods52in-patients with hypertension and30healthy control cases were recruited.32cases with CMBs,20cases without CMBs and30healthy control cases were examined using SWI, DWI and conventional T1weighted imaging (T1WI) and T2weighted imaging (T2WI) by3T MR machine with a32tunnel phase array head coil.All MR images were interpreted by2neuroradiologist independent blinded to clinical history and diagnosis. The lesions’number, location and leukoencephalopathy were recorded. All risk factors were registered including age, sex, blood pressure, hyperlipemia, diabetes, smoking, drinking.Sensitivity of different sequence was evaluated. Spearman correlation analysis was used to analyse the correlation between the number of CMBs and blood pressure, grade of white matter degeneration. Logistic regression analysis was used to assess the relationship of CMBs with the follwing variables:age, sex, blood pressure, hyperlipemia, diabetes, smoking, drinking and white matter degeneration. The SPSS18.0software was applied in this study, statistical difference was granted as P<0.05.Results1. CMBs was founded in32cases of hypertension group and7cases of healthy control group, incidence of CMBs were significantly different in two group (X2=11.134, P=0.001)2. CMBs of hypertension group mainly located in the cortico-subcortical region and basal ganglia area, CMBs of the healthy control mainly located in the cortico-subcortical region. The distribution of CMBs was significantly different in basal ganglia area of two group(P<0.05).3. The number of CMBs in patients with hypertension positively correlated with systolic blood pressure. The number of CMBs in patients with hypertension positively correlated with the grade of white matter degeneration. CMBs were more prevalent with systolic blood pressure, smoking and white matter degeneration(P<0.05).There were no significant relationship demonstrated between CMBs and age, sex, diastolic blood pressure, diabetes, hyperlipemia and drinking.Conclusion1.SWI sequence is most sensitive to detect CMBs comparing with DWI and conventional T,WI and T2WI.2. It was revealed that the frequency of CMBs was significantly high in hypertension group. The distribution of CMBs has a certain rule.3. The number of CMBs in patients with hypertension positively correlated with systolic blood pressure and the grade of white matter degeneration. It proved the importance of controlling blood pressure and treatment of isehemie damage. In patients with CMBs, quit smoking is very necessary.4. SWI was a new sensitive sequence in detecting CMBs. There was extremely vital significance in anticoagulation therapy and Thrombolytic therapy, predicting for hemorrhage in hypertension patients with CMBs.