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Cerebral microbleeds: a guide to detection and interpretation
Steven M Greenberg1, Meike W Vernooij, Charlotte Cordonnier
1Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. sgreenberg@partners.org
Abstract:
Cerebral microbleeds (CMBs) are increasingly recognised neuroimaging findings in individuals with cerebrovascular disease and dementia, and in normal ageing. There has been substantial progress in the understanding of CMBs in recent years, particularly in the development of newer MRI methods for the detection of CMBs and the application of these techniques to population-based samples of elderly people. In this Review, we focus on these recent developments and their effects on two main questions: how CMBs are detected, and how CMBs should be interpreted. The number of CMBs detected depends on MRI characteristics, such as pulse sequence, sequence parameters, spatial resolution, magnetic field strength, and image post-processing, emphasising the importance of taking into account MRI technique in the interpretation of study results. Recent investigations with sensitive MRI techniques have indicated a high prevalence of CMBs in community-dwelling elderly people. We propose a procedural guide for identification of CMBs and suggest possible future approaches for elucidating the role of these common lesions as markers for, and contributors to, small-vessel brain disease.
Insights
Cerebral microbleeds (CMBs) are common in aging and dementia. Newer MRI techniques improve detection, but results depend on imaging methods, influencing interpretation of their role in small-vessel brain disease.
Area of Science:
- Neuroimaging
- Neurology
- Radiology
Background:
- Cerebral microbleeds (CMBs) are recognized neuroimaging findings in cerebrovascular disease, dementia, and normal aging.
- Recent advancements in MRI techniques have significantly improved CMB detection, particularly in elderly populations.
Purpose of the Study:
- To review recent developments in MRI methods for detecting cerebral microbleeds (CMBs).
- To discuss how MRI technique influences the interpretation of CMB detection and prevalence.
- To propose a guide for CMB identification and future research directions.
Main Methods:
- Review of recent literature on MRI techniques for cerebral microbleed (CMB) detection.
- Analysis of factors influencing CMB detection, including MRI pulse sequence, parameters, resolution, field strength, and post-processing.
- Application of sensitive MRI techniques to population-based samples of elderly individuals.
Main Results:
- The number of detected cerebral microbleeds (CMBs) is highly dependent on specific MRI characteristics.
- Sensitive MRI techniques reveal a high prevalence of CMBs in community-dwelling elderly individuals.
- Interpretation of CMBs requires careful consideration of the MRI techniques employed.
Conclusions:
- MRI technique is crucial for accurate cerebral microbleed (CMB) detection and interpretation.
- CMBs are highly prevalent in the elderly, underscoring their significance in small-vessel brain disease.
- Further research is needed to elucidate the role of CMBs as markers and contributors to brain disease.
