Cerebral Microbleeds Correlated Analysis And Classification Of Hypertension

Objective: Susceptibility weighted magnetic resonance imaging to explore the tinybrain of patients with hypertension, hemorrhage (CMBs) and hypertension grading, whitematter degeneration, cerebral lacunar infarct extent relevant, for the clinical treatment ofcerebrovascular disease imaging scientific basis.Materials and methodsRandom collection of November2012to July2013Lianyungang First People’sHospital inpatient or outpatient diagnosis of patients with essential hypertension were174cases,108cases were male, female66cases, with an average age of68years.Cardiovascular risk stratification in hypertensive patients according to the standard willhypertensive patients were divided into low risk, medium risk, high risk and very high-riskgroups of four. All patients underwent brain MRI, including T1WI, T2WI, FLAIRsequence, DWI sequences, SWI sequence, where34cases MRA examination. SWIoriginal inspection data to AW4.4post-processing workstation, using its own software forimage post-processing, and make the minimum density reconstruction. MR images bytwo experienced doctors diagnose nervous system analysis, where one or more deputychief physician of CMBs lesion qualitative and quantitative differences, by the two deputydirector level and above physician determined after consultation. Describe and analyzeconventional MRI and SWI sequence leukoencephalopathy, lacunar infarction andbleeding slightly MRI findings, statistical number and scope of the lesion, and theseverity of white matter lesions, lacunar infarction and micro-grading the degree ofbleeding.All data EXCEL2003establish a database application, application SPSS13.0statistical package for data entry and analysis. SWI sequence on the number of micro-hemorrhage and blood pressure classification, the severity of white matter changes, theextent of cerebral lacunar respectively pearson correlation between the Law and the Spearman rank correlation analysis, with P less than0.05was considered statisticallysignificant.Result174cases of patients with essential hypertension, blood pressure usuallywell controlled in67cases,107cases of poor blood pressure control. Low-risk group of36patients in the risk group of52patients, high-risk group,39cases,47cases of veryhigh-risk group. Among women,66cases positive34cases; male108cases,47casespositive. Gender and no significant correlation between CMBs (χ2=1.053, P value=0.305).MRI examination: the low-risk group of36cases, including14cases found in thesubcortical white matter little patchy long T1, long T2, FLAIR hyperintensity,14patientsfound that small lacunar lesions. Risk group52cases, including34cases of basal gangliaand white matter adjacent to the lateral ventricle area, see multiple small patchy long T1,long T2, FLAIR hyperintensity,40patients see a small lacunar lesions, mainly located inthe basal ganglia and lateral ventricles. High-risk group of39cases, including34cases ofcerebral white matter see spots flaky long T1, long T2, FLAIR hyperintensity, partialfusion,33cases of intracerebral see multiple lacunar lesions, mainly in the basal ganglia,periventricular area, thalamus and brainstem. Extremely high-risk group47cases, ofwhich44cases of white matter regions see patchy long T1, long T2, FLAIRhyperintensity,47cases of intracerebral see multiple lacunar lesions, mainly in the basalganglia and periventricular area, hypothalamus and brainstem, cerebellar hemispheres.The pearson and non-parametric Spearman’s rank sum test, suggesting that the incidenceof lacunar infarction and a positive correlation between CMBs, lacunar CMBs grade leveland the difference was significant, positive correlation between the two.SWI sequence shows81cases of patients with cerebral hemorrhage slightly positive rate of46.5%. The low-risk group:36cases,4cases of hemorrhage found slightly positive rateof11.1%; intermediate risk group,52cases,13cases found that micro-hemorrhage, thepositive rate of25%; risk group39cases,25cases found that micro-hemorrhage, Thepositive rate of64%; very high-risk group47cases,39cases found that micro-hemorrhage, the positive rate of82.9%. Kruskal-wallis test hypertensive group overalldifference between the four groups chi-square Chi-Square=57.774, p <0.001, Spearmanrank test results: rs=0.567, P=0.000, prompted hypertension positive results amongvarious groups have significant differences, CMBs and positive correlation between hypertension group. All patients were found in the basal ganglia hemorrhage123micro,subcortical areas were found in120micro-hemorrhage, were found in66micro-thalamichemorrhage, brainstem lesions were found in50,24lesions were found in the cerebellum.Spearman’s rank correlation coefficient rs=0.567, P=0.001, tips CMBs number ofhypertensive patients blood pressure classification significantly correlated.White matter degeneration of a total of more than156cases,81cases occurred CMBs,positive rate of about51.9%. Where022patients,2cases discovered micro hemorrhage,the positive rate of9.1%;1patient in53cases, seven cases found in micro-hemorrhage,the positive rate of13.2%;247patients,30cases found that micro-hemorrhage, positiverate of63.8%;3patients with54cases,42cases found that micro-hemorrhage, thepositive rate of82.3%. The statistical test, the number and level of hypertensive patientswith CMBs grading of white matter degeneration significant differences between the twowere positively correlated.Conclusion （1）grade of hypertension, cerebral, leukoaraiosis lacunar infarction andthe extent of CMBs number and severity（.2）CMBs, suggesting that vascular wall damage,is a sign of microvascular disease. The number and classification reflects the cerebralmicrovascular damage（.3）CMBs can be used to predict symptomatic cerebral hemorrhage,has the important instruction function to the clinical application of anticoagulant andthrombolytic drugs.