Preliminary Study Of Essential Hypertension Complicated By Cerebral Microbleeds Using Enhanced T2Star Weighted Angiography

Objective:To investigate the application value of the ESWAN sequence in diagnosis of cerebral microbleeds (CMBs) in patients with essential hypertension (EH); To explore the distribution of CMBs in patients with essential hypertension;To explore the clinical application value of CPV provided by ESWAN sequence.Methods:31cases with EH complicated by CMBs, and20healthy, age-and gender-matched controls underwent conventional MRI and ESWAN sequences using U.S.A GE company Signa HDX3.0T MR scanner. Positive rates of both ESWAN and generic sequences for CMBs lesions were determined in patients with EH. Diagnostic agreement of grading of CMBs lesion numbers was compared between different observers and patients with EH. Morbidities of CMBs lesions in different positions were compared among patients with EH. Mean CPVs were compared between the CMBs lesions in patients with EH and the red nuclei and substantia nigra in healthy controls. CPVs of CMBs lesions in different positions and the baseline data of EH patients were analyzed.Results:The ESWAN sequence was significantly more positive for CMBs lesions than the generic sequence. Different observers were in good agreement with grades of CMBs lesion numbers of ESWAN sequence. Of the31patients with EH, a total of127CMBs lesions were found, among which basal ganglia/thalamus had the highest morbidity, followed by cortical-subcortical region and subtentorial region. All CPVs of CMBs lesions were valued between-0.73rad and0.23rad with a mean of-0.45rad. There was significant difference among mean CPVs of CMBs lesions in all positions. In patients with EH, mean CPVs of CMBs lesions in all positions were lower than those of red nuclei and substantia nigra in healthy controls. Formean CPVs of CMBs lesions in basal ganglia/thalamus and cortical-subcortical regions, patients aged≥65were higher than those aged <65; for mean CPVs of CMBs lesions in cortical-subcortical regions, those at high/very high risk of EH and with course≥10years were lower than those at low-to-moderate risk and with course<10years; for mean CPVs of CMBs lesions in basal ganglia/thalamus, EH patients complicated with leukoaraiosis (LA) and lacunar infarction (LI) were higher than those without LA and LI; for mean CPVs of CMBs lesions in cortical-subcortical regions, EH patients complicated with LI were higher than those without LI. Mean CPVs of CMBs lesions in basal ganglia/thalamus were negatively correlated with age, course of EH and systolic pressure of the hypertensive patient, whereas those in cortical-subcortical regions negatively with age, hypertension grading and course of EH. Mean CPVs of CMBs lesions in basal ganglia/thalamus and cortical-subcortical regions were positively correlated with the presence of LI, whereas those in basal ganglia/thalamus with the presence of LA.Conclusion:ESWAN sequences are superior to generic sequences in detection of CMBs lesions, with better repeatability; For patients with primary hypertension, there is a difference in morbidity of CMBs lesions among different intracerebral regions, in descending order, being basal ganglia/thalamus,cortical-subcortical and subtentorial regions; Measur-ement of CPVs of CMBs lesions in different intracerebral regions and establishment of corresponding reference ranges provide a more reliable quantitative indicator for safe and noninvasive understanding of the iron content in the CMBs lesion and play a significant role in further investigation of pathological changes, clinical progression and prognosis of CMBs.