MRI evidence of past cerebral microbleeds in a healthy elderly population
MRI evidence of past cerebral microbleeds in a healthy elderly population
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DOI：
10.1212/wnl.52.5.991
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发表时间：
1999-03-23
期刊：
影响因子：
9.9
通讯作者：
Fazekas, F
中科院分区：
文献类型：
--
作者：
Roob, G;Schmidt, R;Fazekas, F
背景资料：非外伤性脑出血患者在梯度回波T2（*）加权MRI上常发现提示既往微出血的偶发性信号丢失病灶，并与出血倾向性微血管病相关。这种病变是否以及在多大程度上也可能发生在正常人群中尚不清楚。目的：确定无症状老年人的局灶性低信号及其与其他临床和形态学变量的关系。研究方法：在奥地利卒中预防研究的280名参与者（平均年龄60岁，范围44至79岁）的连续系列中进行了脑部T2（*）加权MRI。该队列由随机选择的无神经精神障碍病史或体征的个体组成。结果：18例（6.4%）患者既往微出血，范围为1 - 5个信号丢失灶。它们与较高的年龄、高血压和腔隙密切相关（p < 0.001），广泛的白色损害更常见（p = 0.02）。高血压存在于基底节和幕下局灶性低信号的所有个体中，但仅5/10名志愿者的微出血仅限于皮质-皮质下部位（p = 0.04）。结论：即使在神经系统正常的老年人中也可能发现既往微出血的MRI证据，并且与小血管疾病的其他指标相关，但不限于此。这一发现对脑出血风险的预测潜力需要进一步研究。
Background: Incidental foci olf signal loss suggestive of past microbleeds are a frequent finding on gradient-echo T2(*)-weighted MRI of patients with nontraumatic intracerebral hemorrhage and have been associated with bleeding-prone microangiopathy. If and to what extent such lesions may also occur in the normal population is unclear. Objective: To determine focal hypointensities in asymptomatic elderly individuals and their relation to other clinical and morphologic variables. Methods: T2(*)-weighted MRI of the brain was performed in a consecutive series of 280 participants (mean age 60 years, range 44 to 79) of the Austrian Stroke Prevention Study. This cohort consisted of randomly selected individuals without history or signs of neuropsychiatric disorder. Results: Past microbleeds ranging from one to five foci of signal loss were seen in 18 (6.4%) individuals. They were strongly associated with higher age, hypertension, and lacunes (p < 0.001), and extensive white matter damage was more frequently noted (p = 0.02). Hypertension was present in all individuals with focal hypointensities in the basal ganglia and infratentorially but in only 5 of 10 volunteers with microbleeds limited to cortico-subcortical sites (p = 0.04). Conclusions: MRI evidence of past microbleeds may be found even in neurologically normal elderly individuals and is related, but not restricted, to other indicators of small vessel disease. The predictive potential of this finding regarding the risk of' intracerebral bleeding requires further investigation.