Roob G, Schmidt R, Kapeller P, Lechner A, Hartung H P, Fazekas F
Department of Neurology, Karl-Franzens University, Graz, Austria.
Neurology. 1999 Mar 23;52(5):991-4. doi: 10.1212/wnl.52.5.991.
Incidental foci of signal loss suggestive of past microbleeds are a frequent finding on gradient-echo T2-weighted MRI of patients with nontraumatic intracerebral hemorrhage and have been associated with bleeding-prone microangiopathy. If and to what extent such lesions may also occur in the normal population is unclear.
To determine focal hypointensities in asymptomatic elderly individuals and their relation to other clinical and morphologic variables.
T2-weighted MRI of the brain was performed in a consecutive series of 280 participants (mean age 60 years, range 44 to 79) of the Austrian Stroke Prevention Study. This cohort consisted of randomly selected individuals without history or signs of neuropsychiatric disorder.
Past microbleeds ranging from one to five foci of signal loss were seen in 18 (6.4%) individuals. They were strongly associated with higher age, hypertension, and lacunes (p < 0.001), and extensive white matter damage was more frequently noted (p = 0.02). Hypertension was present in all individuals with focal hypointensities in the basal ganglia and infratentorially but in only 5 of 10 volunteers with microbleeds limited to cortico-subcortical sites (p = 0.04).
MRI evidence of past microbleeds may be found even in neurologically normal elderly individuals and is related, but not restricted, to other indicators of small vessel disease. The predictive potential of this finding regarding the risk of intracerebral bleeding requires further investigation.
在非创伤性脑出血患者的梯度回波T2加权磁共振成像（MRI）上，经常发现提示既往微出血的信号丢失偶然病灶，且与易出血的微血管病变有关。目前尚不清楚此类病变在正常人群中是否会出现以及出现的程度如何。
确定无症状老年人中的局灶性低信号及其与其他临床和形态学变量的关系。
对奥地利卒中预防研究中连续纳入的280名参与者（平均年龄60岁，范围44至79岁）进行脑部T2加权MRI检查。该队列由随机选择的无神经精神疾病病史或体征的个体组成。
18名（6.4%）个体出现了1至5个信号丢失灶的既往微出血。它们与高龄、高血压和腔隙性脑梗死密切相关（p<0.001），并且更常发现广泛的白质损伤（p=0.02）。所有基底节和幕下有局灶性低信号的个体均有高血压，但10名微出血仅限于皮质-皮质下部位的志愿者中只有5名有高血压（p=0.04）。
即使在神经系统正常的老年人中也可能发现既往微出血的MRI证据，且其与小血管疾病的其他指标有关，但并不局限于此。这一发现对于脑出血风险的预测潜力需要进一步研究。
