Department of Radiology, University of Palermo, Palermo, Italy.
Department of Diagnostic and Therapeutic Services, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, Italy.
Radiol Med. 2018 Jun;123(6):441-448. doi: 10.1007/s11547-018-0863-x. Epub 2018 Feb 17.
Cerebral microbleeds (CMBs) are small rounded lesions representing cerebral hemosiderin deposits surrounded by macrophages that results from previous microhemorrhages. The aim of this study was to review the distribution of cerebral microbleeds in patients with end-stage organ failure and their association with specific end-stage organ failure risk factors.
Between August 2015 and June 2017, we evaluated 15 patients, 9 males, and 6 females, (mean age 65.5 years). Patients population was subdivided into three groups according to the organ failure: (a) chronic kidney failure (n = 8), (b) restrictive cardiomyopathy undergoing heart transplantation (n = 1), and (c) end-stage liver failure undergoing liver transplantation (n = 6). The MR exams were performed on a 3T MR unit and the SWI sequence was used for the detection of CMBs. CMBs were subdivided in supratentorial lobar distributed, supratentorial non-lobar distributed, and infratentorial distributed.
A total of 91 microbleeds were observed in 15 patients. Fifty-nine CMBs lesions (64.8%) had supratentorial lobar distribution, 17 CMBs lesions (18.8%) had supratentorial non-lobar distribution and the remaining 15 CMBs lesions (16.4%) were infratentorial distributed. An overall predominance of supratentorial multiple lobar localizations was found in all types of end-stage organ failure. The presence of CMBs was significantly correlated with age, hypertension, and specific end-stage organ failure risk factors (p < 0.001).
CMBs are mostly founded in supratentorial lobar localization in end-stage organ failure. The improved detection of CMBs with SWI sequences may contribute to a more accurate identification of patients with cerebral risk factors to prevent complications during or after the organ transplantation.
脑微出血(CMB)是指由巨噬细胞围绕的先前微出血引起的代表脑含铁血黄素沉积的小圆形病变。本研究的目的是回顾终末期器官衰竭患者的脑微出血分布及其与特定终末期器官衰竭危险因素的关系。
在 2015 年 8 月至 2017 年 6 月期间,我们评估了 15 名患者,其中男性 9 名,女性 6 名,(平均年龄 65.5 岁)。根据器官衰竭将患者人群分为三组:(a)慢性肾衰竭(n=8),(b)限制性心肌病行心脏移植(n=1),(c)终末期肝功能衰竭行肝移植(n=6)。MR 检查在 3T MR 仪上进行,SWI 序列用于检测 CMB。CMB 分为幕上叶分布、幕上非叶分布和幕下分布。
在 15 名患者中观察到 91 个 CMB。59 个 CMB 病变(64.8%)呈幕上叶分布,17 个 CMB 病变(18.8%)呈幕上非叶分布,其余 15 个 CMB 病变(16.4%)呈幕下分布。在所有类型的终末期器官衰竭中,均发现幕上多个叶分布的总体优势。CMB 的存在与年龄、高血压和特定终末期器官衰竭危险因素显著相关(p<0.001)。
CMB 主要存在于终末期器官衰竭的幕上叶分布。SWI 序列对 CMB 的检测提高有助于更准确地识别具有脑危险因素的患者,以预防器官移植期间或之后的并发症。