Cerebral Microbleeds Remain for Nine Years: A Prospective Study with Yearly Magnetic Resonance Imaging
Cerebral Microbleeds Remain for Nine Years: A Prospective Study with Yearly Magnetic Resonance Imaging
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DOI：
10.1016/j.jstrokecerebrovasdis.2017.09.001
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发表时间：
2018-02-01
影响因子：
2.5
通讯作者：
Hasebe, Naoyuki
中科院分区：
文献类型：
--
作者：
Saito, Tsukasa;Kawamura, Yuichiro;Hasebe, Naoyuki
背景资料：脑微出血（CMB）是在T2* 加权梯度回波（GRE）磁共振成像（MRI）上检测到的精细神经影像学表现，被广泛认为是脑小血管脆弱性的重要标志。有必要通过纵向研究进一步阐明CMB的自然历史。本研究旨在通过前瞻性的长期观测，揭示CMB的自然历史，寻找更好的跟踪CMB的方法。研究方法：我们对8例在基线MRI中检测到CMB的非瓣膜性房颤日本门诊患者进行了7年或更长时间的年度脑部MRI评估。我们也从2012年开始使用3.0T MRI扫描仪。结果：随访9年3例，8年2例，7年3例。在所有患者中，基线时的CMB在随访期间没有消失。重要的是，1例患者的CMB在使用1.5T T2*-加权GRE的第6次成像期间似乎消失，但在使用3.0T磁敏感加权成像的第7次成像和使用3.0T T2*-GRE的第9次成像期间再次检测到。此外，在植入起搏器的患者中，目前仅适用于1.5T MRI，CMB似乎消失，并在层厚为2.5 mm而不是5 mm的1.5T T2* 加权GRE中再次出现。结论：从这项前瞻性研究中，我们获得了两个绝对新的发现，即CMB保留长达9年，高场或薄层MRI可以检测到隐藏的CMB。
Background: Cerebral microbleeds (CMBs) are refined neuroimaging findings detected on T2*-weighted gradient echo (GRE) magnetic resonance imaging (MRI) and are widely accepted as an important marker of the vulnerability of cerebral small vessels. It is necessary to further clarify the natural history of CMBs by a longitudinal study. This study aimed to reveal the natural history of CMBs and find a better way to track CMBs by a prospective long-term observation. Methods: We performed yearly brain MRI assessments for 7 or more years in 8 nonvalvular atrial fibrillation Japanese outpatients with CMBs detected in the baseline MRI. We began to use a 3.0T MRI scanner from 2012 as well. Results: We followed up 3 patients for 9 years, 2 for 8 years, and 3 for 7 years. In all patients, the CMBs at baseline did not disappear during the follow-up period. Importantly, the CMB in 1 patient seemed to disappear during the sixth imaging using 1.5T T2*-weighted GRE but was detected again during the seventh imaging with 3.0T susceptibility weighted imaging and ninth imaging with 3.0T T2*-GRE. Moreover, in a patient implanted with a pacemaker, which is only applicable for 1.5T MRI at present, the CMB seemed to disappear and appeared once again with a 1.5T T2*-weighted GRE at a slice thickness of 2.5 mm instead of 5 mm. Conclusions: From this prospective study, we obtained 2 absolutely new findings that CMBs remained for as long as 9 years and a high-field or thin-slice MRI can detect concealed CMBs.