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Cerebral Microbleeds Detected Using 3.0T Magnetic Resonance Imaging in 2,003 Patients with Ischemic or Hemorrhagic
Tetsuya Abe1,2, Masaki Takao1,3, Hiroaki Kimura3
1Department of Neurology, Saitama Medical University International Medical Center, Hidaka, Japan.
Introduction:
Compared with 1.5T magnetic resonance imaging (MRI), using 3.0T MRI makes it easier to detect cerebral microbleeds (CMBs). We used 3.0T MRI to investigate the backgrounds, risk factors, and number and location of CMBs in patients with ischemic or hemorrhagic stroke.
Methods:
We extracted data on clinical characteristics, risk factors, and number and location of CMBs in 2,003 patients treated between January 2010 and December 2014 within one week of stroke occurrence. We then carried out multivariate analysis of the data.
Results:
CMBs were present in 1,025 patients. The numbers of CMBs in ischemic stroke and hemorrhagic stroke patients were 9,410 and 6,419, respectively. Patients with CMBs showed significantly higher rates of cognitive impairment (p < 0.001, odds ratio [OR] = 1.514), hypertension (p < 0.001, OR = 3.145), previous history of stroke (p < 0.001, OR = 1.782), and presence of hemorrhagic stroke (p < 0.001, OR = 2.066). The use of antithrombotic medication before the stroke did not affect the incidence of CMBs. In ischemic stroke patients, patients with small vessel occlusion had a significantly greater rate of previous history of hemorrhagic stroke (p = 0.046) and number of patients with CMBs (p < 0.001) than those with cardioembolism.
Conclusions:
CMBs were well observed in patients with small vessel disease, and hypertension was an important factor in ischemic and hemorrhagic stroke. Antithrombotic medication is not associated with the development of CMBs if adequate antihypertensive therapy is provided.
Insights
Cerebral microbleeds (CMBs) are common in stroke patients, particularly those with hypertension and a history of stroke. 3.0T MRI effectively detects CMBs, which are linked to cognitive impairment.
Area of Science:
- Neurology
- Radiology
- Stroke Research
Background:
- 3.0T MRI enhances detection of cerebral microbleeds (CMBs) compared to 1.5T MRI.
- Cerebral microbleeds are associated with various stroke types and risk factors.
Purpose of the Study:
- To investigate the prevalence, characteristics, and risk factors of CMBs in patients with ischemic or hemorrhagic stroke using 3.0T MRI.
- To analyze the number and location of CMBs in relation to stroke type and patient history.
Main Methods:
- Retrospective analysis of clinical data from 2,003 stroke patients treated between January 2010 and December 2014.
- Multivariate analysis to identify risk factors and associations with CMBs.
Main Results:
- CMBs were detected in 1,025 patients (51.2%).
- Significant associations found between CMBs and cognitive impairment, hypertension, prior stroke history, and hemorrhagic stroke.
- Patients with small vessel occlusion had a higher incidence of CMBs and prior hemorrhagic stroke history compared to cardioembolic stroke patients.
Conclusions:
- Hypertension is a key factor in both ischemic and hemorrhagic strokes with CMBs.
- CMBs are prevalent in small vessel disease, and antithrombotic medication use does not impact CMB development with adequate antihypertensive therapy.
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