Related Experiment Videos
Multifocal low-signal brain lesions on T2*-weighted gradient-echo imaging
1Department of Radiology, National Defence Medical, College, Japan. yoshito@xa2.so-net.ne.jp
Abstract:
Multifocal small low-signal lesions on T2*-weighted gradient-echo (GE) MRI are reported to be common in the brain of hypertensive patients. We examined factors associated with these lesions. For one year, we routinely obtained T2*-weighted GE images (TR 1000 TE 30 ms, flip angle = 20 degrees) in all adult patients (314) who underwent brain MRI in our hospital, using a 1.5 T superconducting magnet. Patients with multifocal small low-signal lesions with a known or presumed pathogenesis or any condition which may cause intracerebral haemorrhage, such as brain tumours, were excluded from further analysis. Thus, 191 cases remained (104 men and 87 women; age, 62.8+/-11.0 years, range, 30-89 years). The overall prevalence of multifocal small low-signal lesions on the GE images was 15.2% (29/191); they were commonly in the cerebral white matter and basal ganglia. They were detected in 12 (52.2%) of the 23 patients with prior symptomatic brain hemorrhage, 12 (20.7%) of the 58 with prior symptomatic infarcts, and only five (4.5%) of 110 without a prior stroke. Logistic regression analysis indicated that multifocal small low-signal lesions were significantly correlated with a symptomatic acute brain haemorrhage (odds ratio, 13.17), chronic hypertension (4.00) and a symptomatic acute infarct (3.71). The association with symptomatic acute brain haemorrhage suggests that this finding may represent subclinical microhaemorrhage. The diagnostic potential of this finding to identify individuals at risk of symptomatic intracerebral haemorrhage may require further investigation.
Insights
Multifocal small low-signal lesions on T2*-weighted gradient-echo (GE) MRI are linked to brain hemorrhages and hypertension. These findings may indicate subclinical microhemorrhages, suggesting potential for risk assessment in patients with stroke history.
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.