脑微出血——无大面积脑梗死既往史的东北人群的患病率、分布及危险因素。

Cerebral microbleeds - prevalence, distribution and risk factors in northeast population without preceding large-area stroke.

机构信息

Department of Neuroradiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100050, China.

出版信息

Chin Med J (Engl). 2010 Feb 5;123(3):286-90.

PMID:20193246

Abstract

BACKGROUND

Cerebral microbleeds (CMBs) occur frequently in patients suspected of cerebrovascular disease and they are the principle radiographic findings in patients with sub-clinical neurological impairment. The objective of this study was to assess the prevalence, distribution, severity and associated clinical features of CMBs in a prospective hospital patient based cohort undergoing brain MRI for suspected cerebrovascular disease, excluding cases with known intracranial hemorrhage or prior large-area stroke.

METHODS

The study population consisted of 447 patients who were evaluated with T2*-gradient echo sequences to detect the CMBs lesion number, location, and their association with white matter hyperintensities and clinical parameters, including blood pressure.

RESULTS

CMB lesions were presented in 95 of the 447 patients (21.3%). The distribution of CMBs was 43.95% cortical, 19.77% thalamic, 14.41% in the brainstem, 11.58% cerebellar, 6.21% periventricular white matter, 5.64% involving the basal ganglia regions, and 0.28% involving the hippocampus. There was a statistically significant association between the presence of CMBs and advancing age (adjusted OR 2.082, P < 0.01), the severity of hypertension (adjusted OR 2.208, P < 0.01). Also there was a statistically significant (P < 0.01) correlation between the presence of CMBs and the severity of hypertension and white matter lesions.

CONCLUSIONS

CMBs occur frequently in patients with no prior large-area stroke who were referred for brain MRI for suspected cerebrovascular disease. The severity of CMBs correlates with the severity of hypertension and the presence of cerebral white matter changes detected by MRI.

摘要

背景

脑微出血（CMBs）在疑似脑血管病患者中较为常见，是亚临床神经功能障碍患者的主要影像学发现。本研究旨在评估疑似脑血管病患者行脑部 MRI 检查时，CMBs 的患病率、分布、严重程度及其与临床特征（包括血压）的相关性，排除已知颅内出血或大面积脑梗死患者。

方法

研究人群为 447 例患者，均采用 T2*-梯度回波序列评估 CMB 病灶数量、位置，及其与脑白质高信号和临床参数（包括血压）的相关性。

结果

447 例患者中 95 例（21.3%）存在 CMB 病灶。CMBs 分布为皮质 43.95%、丘脑 19.77%、脑干 14.41%、小脑 11.58%、脑室周围白质 6.21%、基底节区 5.64%、海马区 0.28%。CMBs 与年龄增长（校正 OR 2.082，P<0.01）、高血压严重程度（校正 OR 2.208，P<0.01）相关。CMBs 与高血压严重程度及 MRI 检测到的脑白质病变存在显著相关性（P<0.01）。