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Cerebral microbleeds: from depiction to interpretation.

Laurent Puy1, Marco Pasi1, Mark Rodrigues2

  • 1Department of Neurology, U1172 - LilNCog - Lille Neuroscience & Cognition, Univ. Lille, Inserm, CHU Lille, F-59000 Lille, France.

Journal of Neurology, Neurosurgery, and Psychiatry
|February 10, 2021
PubMed
Summary

Cerebral microbleeds (CMBs) on MRI indicate microhaemorrhages, aiding in assessing small vessel disease severity. Harmonizing MRI techniques is crucial for reliable detection and clinical decision-making regarding vascular events.

Keywords:
MRIcerebrovascular diseasecognitionstroke

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Area of Science:

  • Neuroradiology
  • Neuropathology
  • Vascular Neurology

Background:

  • Cerebral microbleeds (CMBs) are MRI-detected hypointensities, increasingly found in healthy individuals and those with cerebrovascular disease or dementia.
  • Postmortem neuropathology confirms CMBs often represent microhaemorrhages, particularly in cerebrovascular disease contexts.
  • CMBs are also observed in critical conditions, including patients on extracorporeal mechanical oxygenation.

Purpose of the Study:

  • To review the diagnostic and prognostic value of cerebral microbleeds (CMBs).
  • To discuss clinical dilemmas associated with CMB detection, especially concerning antithrombotic and reperfusion therapies.
  • To highlight the need for harmonized MRI parameters for improved cross-study comparisons.

Main Methods:

  • Review of MRI findings, focusing on T2*-weighted and susceptible-weighted sequences.
  • Integration of MRI-guided postmortem neuropathological examination data.
  • Analysis of clinical implications and diagnostic/prognostic utility of CMBs.

Main Results:

  • CMB detection is sensitive to MRI field strength, postprocessing, and sequence types.
  • Harmonization of imaging parameters is necessary for reliable cross-study comparisons.
  • CMBs serve as valuable markers for small vessel disease nature and severity.

Conclusions:

  • Cerebral microbleeds are significant indicators of underlying cerebrovascular pathology.
  • Standardizing MRI acquisition and analysis is essential for consistent CMB assessment.
  • CMBs hold potential as diagnostic and prognostic markers for future vascular events.