Yokoyama Shunichi, Hirano Hirofumi, Uomizu Kenji, Kajiya Yoriko, Tajitsu Kenichiro, Kusumoto Kazuhiro
Division of Neurosurgery, Nanpuh Hospital, Kagoshima, Japan.
Neurol Med Chir (Tokyo). 2005 Nov;45(11):556-60; discussion 560. doi: 10.2176/nmc.45.556.
The incidence and characteristics of microbleeds in hemodialysis (HD) patients were investigated to elucidate the clinical significance with T(2)()-weighted gradient-echo magnetic resonance (MR) imaging. The 57 patients with chronic renal failure maintained by HD had no previous history of stroke. The control group consisted of 53 patients without previous history of stroke or chronic renal failure. The incidence and the number of microbleeds were assessed in the HD and control groups. The findings of microbleeds with T(2)()-weighted gradient-echo MR imaging were compared with those of T(1)- and T(2)-weighted MR imaging in HD patients. The incidence of microbleeds was significantly greater in the HD patients compared with the control patients. T(2)()-weighted gradient-echo imaging revealed a total of 44 microbleeds in 11 HD patients. T(2)-weighted imaging demonstrated 13 of 44 microbleeds as hyperintensity, whereas T(1)-weighted imaging demonstrated 12 lesions as hypointensity. T(2)- and T(1)-weighted imagings did not demonstrate any findings in 31 and 32 lesions, respectively. T(2)()-weighted gradient-echo MR imaging is effective to detect microbleeds which may be a predictor of intracerebral hemorrhage in HD patients and should be included in the protocol for the study of cerebrovascular disease, because T(2)- and T(1)-weighted MR imaging recognizes microbleeds as lacunar infarction.
采用T(2)()加权梯度回波磁共振(MR)成像技术,对血液透析(HD)患者微出血的发生率及特征进行研究,以阐明其临床意义。57例维持性血液透析的慢性肾衰竭患者既往无卒中病史。对照组由53例无卒中病史及慢性肾衰竭的患者组成。评估HD组和对照组微出血的发生率及数量。将HD患者T(2)()加权梯度回波MR成像显示的微出血表现与T(1)加权和T(2)加权MR成像结果进行比较。HD患者微出血的发生率显著高于对照组患者。T(2)()加权梯度回波成像显示11例HD患者共有44处微出血。T(2)加权成像显示44处微出血中有13处为高信号,而T(1)加权成像显示12处病变为低信号。T(2)加权和T(1)加权成像分别在31处和32处病变中未显示任何异常。T(2)()加权梯度回波MR成像对于检测微出血有效,微出血可能是HD患者脑出血的一个预测指标,应纳入脑血管疾病研究方案,因为T(2)加权和T(1)加权MR成像将微出血识别为腔隙性梗死。