Multifocal low-signal brain lesions on T2*-weighted gradient-echo imaging

Area of Science:

• Neurology
• Radiology
• Medical Imaging

Background:

• Multifocal small low-signal lesions on T2*-weighted gradient-echo (GE) MRI are frequently observed in hypertensive individuals.
• The precise factors associated with these brain lesions require further elucidation.

Purpose of the Study:

• To investigate the prevalence and associated factors of multifocal small low-signal lesions on T2*-weighted GE MRI in adult patients undergoing brain MRI.

Main Methods:

• A prospective study was conducted over one year, analyzing T2*-weighted GE MRI scans from 191 adult patients (excluding those with known causes of hemorrhage or tumors).
• Data on patient history, including symptomatic brain hemorrhage, infarcts, and hypertension, were collected and analyzed using logistic regression.

Main Results:

• The overall prevalence of these lesions was 15.2%, predominantly in the cerebral white matter and basal ganglia.
• Lesions were significantly correlated with symptomatic acute brain hemorrhage (odds ratio [OR], 13.17), chronic hypertension (OR, 4.00), and symptomatic acute infarct (OR, 3.71).
• Patients with prior symptomatic brain hemorrhage showed the highest prevalence (52.2%).

Conclusions:

• Multifocal small low-signal lesions on T2*-weighted GE MRI are strongly associated with symptomatic acute brain hemorrhage, suggesting they may represent subclinical microhemorrhages.
• These findings hold potential diagnostic value for identifying individuals at risk of symptomatic intracerebral hemorrhage, warranting further investigation.