Comparison of 7.0-T T2*-Magnetic Resonance Imaging of Cerebral Bleeds in Post-Mortem Brain Sections of Alzheimer Patients with Their Neuropathological Correlates
Comparison of 7.0-T T2*-Magnetic Resonance Imaging of Cerebral Bleeds in Post-Mortem Brain Sections of Alzheimer Patients with Their Neuropathological Correlates
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DOI：
10.1159/000324391
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发表时间：
2011-01-01
影响因子：
2.9
通讯作者：
Leys, D.
中科院分区：
文献类型：
--
作者：
De Reuck, J.;Auger, F.;Leys, D.
背景：鉴于MRI对脑微出血(MCB)的认识越来越高，有必要验证脑血管疾病和痴呆患者死后脑中MCB的检测。材料和方法：对20例有不同脑血管病变的阿尔茨海默病患者尸检脑标本，对45例大脑半球、脑干、小脑进行7.0TT2加权成像，并与血肿、微出血(MCB)和少量出血(MNBs)的组织学检测进行比较。结果：T-2*显像检测MCBs和MNBs的灵敏度、特异度、阳性预测值和阴性预测值对皮质下区MCBs和MNBs的敏感性、特异性、阳性预测值和阴性预测值均较高。由于与陈旧性出血无关的铁沉积，纹状体中的MNBs被显著高估。此外，在深层白质中，42%的MNBs未被检测到，而31%的T-2*低信号不是MNBs所致，而是死后血栓填充的血管所致。结论：在用7.0TT2*加权MRI评估痴呆患者尸脑切片出血负荷和血管危险因素时，只有皮质下区域的少量脑出血才是可靠的。版权所有(C)2011 S.Karger AG，巴塞尔
Background: In view of the increasing recognition of cerebral microbleeds (MCBs) with MRI, there is a need to validate their detection in post-mortem brains in patients with cerebrovascular diseases and dementia. Materials and Methods: Out of 20 post-mortem brains of patients with Alzheimer dementia and with different cerebrovascular lesions, 45 large sections of the cerebral hemispheres, brainstem and cerebellum were submitted to a 7.0-T T-2*-weighted MRI, and afterwards compared to the histological detection of haematomas, MCBs and mini-bleeds (MNBs). Results: The sensitivity, specificity, predictive positive value and predictive negative value of the T-2* imaging to detect MCBs and MNBs were excellent for those in the cortico-subcortical regions. There was a significant overestimation of MNBs in the striatum due to iron deposits unrelated to old haemorrhages. Also in the deep white matter, 42% of MNBs were not detected, while 31% of T-2* hyposignals were not due to MNBs but to vessels filled with post-mortem thrombi. Conclusions: When evaluating the 'bleeding load' with 7.0-T T-2* weighted MRI in post-mortem brain sections of patients with dementia and vascular risk factors, only quantification of small cerebral bleeds in the cortico-subcortical regions is reliable. Copyright (C) 2011 S. Karger AG, Basel