Greenberg Steven M, Vernooij Meike W, Cordonnier Charlotte, Viswanathan Anand, Al-Shahi Salman Rustam, Warach Steven, Launer Lenore J, Van Buchem Mark A, Breteler Monique Mb
Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA.
Lancet Neurol. 2009 Feb;8(2):165-74. doi: 10.1016/S1474-4422(09)70013-4.
Cerebral microbleeds (CMBs) are increasingly recognised neuroimaging findings in individuals with cerebrovascular disease and dementia, and in normal ageing. There has been substantial progress in the understanding of CMBs in recent years, particularly in the development of newer MRI methods for the detection of CMBs and the application of these techniques to population-based samples of elderly people. In this Review, we focus on these recent developments and their effects on two main questions: how CMBs are detected, and how CMBs should be interpreted. The number of CMBs detected depends on MRI characteristics, such as pulse sequence, sequence parameters, spatial resolution, magnetic field strength, and image post-processing, emphasising the importance of taking into account MRI technique in the interpretation of study results. Recent investigations with sensitive MRI techniques have indicated a high prevalence of CMBs in community-dwelling elderly people. We propose a procedural guide for identification of CMBs and suggest possible future approaches for elucidating the role of these common lesions as markers for, and contributors to, small-vessel brain disease.
脑微出血（CMBs）在脑血管疾病和痴呆患者以及正常衰老个体中越来越被视为一种神经影像学表现。近年来，在对CMBs的认识方面取得了重大进展，特别是在开发用于检测CMBs的更新MRI方法以及将这些技术应用于基于人群的老年样本方面。在本综述中，我们重点关注这些最新进展及其对两个主要问题的影响：如何检测CMBs以及如何解读CMBs。检测到的CMBs数量取决于MRI特征，如脉冲序列、序列参数、空间分辨率、磁场强度和图像后处理，这强调了在解释研究结果时考虑MRI技术的重要性。近期使用敏感MRI技术的调查表明，社区居住老年人中CMBs的患病率很高。我们提出了一个识别CMBs的程序指南，并建议了未来可能的方法，以阐明这些常见病变作为小血管脑疾病的标志物和促成因素的作用。
