Quantitative assessment and correlation analysis of cerebral microbleed distribution and leukoaraiosis in stroke outpatients.
OBJECTIVE
Cerebral microbleeds (CMBs) are bleeding events associated with cerebral small vessel disease (SVD). Strictly lobar CMBs and strictly deep CMBs are likely caused by cerebral amyloid angiopathy (CAA) and hypertensive arteriopathy, respectively. Leukoaraiosis (LA) reflects an ischaemic change in SVD, and LA severity has been correlated with CMBs. However, whether different locations (aetiologies) of CMBs correlate with LA is unknown.


METHODS
Patients receiving brain MRI and tbl2*-weighted gradient-recalled echo scans in a stroke outpatient department were screened for CMBs. The MRI results of the patients with CMBs were sent to investigators for further review and were evaluated using the Microbleed Anatomical Rating Scale. Cerebral microbleed severity was graded using a numerical scale. Leukoaraiosis severity was assessed using the Fazekas scale.


RESULTS
Cerebral microbleeds were observed in 14.6% of the 1289 screened patients. The CMB incidence increased with age (in years, < 50: 1.3%; 50-59: 10.7%; 60-69: 17.6% and ≥ 70: 23.6%; P = 0.000). The CMB locations were distributed as follows: 23.4% strictly lobar, 12.2% strictly deep, 6.4% strictly infratentorial and 58.0% mixed. Cerebral microbleed severity correlated with the total Fazekas scale score. The numbers of lobar, deep and infratentorial CMBs correlated with the total Fazekas scale score. The mixed CMB group displayed a significantly higher Fazekas scale score than the strictly lobar CMB group (P = 0.000).


DISCUSSION
Cerebral microbleed incidence increased with age. Mixed CMB type displayed the highest incidence. The severity and number of CMBs at any location correlated with LA severity. These results suggested interactions between hypertension and CAA during LA progression.
['Yang|Qiong|Q|', 'Yang|Yan|Y|', 'Li|Chengyu|C|', 'Li|Jian|J|', 'Liu|Xiangyi|X|', 'Wang|Aonan|A|', 'Zhao|Jialing|J|', 'Wang|Mengyuan|M|', 'Zeng|Xiangzhu|X|', 'Fan|Dongsheng|D|']
D000328:Adult D000368:Aged D001921:Brain D002543:Cerebral Hemorrhage D005260:Female D006801:Humans D049292:Leukoaraiosis D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D012720:Severity of Illness Index D020521:Stroke
Leukoaraiosis Cerebral amyloid angiopathy, Cerebral microbleeds, Distribution, Gradient-recalled echo,