The value of various MRI sequences for detection of cerebral microbleeds in hypertensive patients

Objective To compare the detectability of cerebral microbleeds (CMBs) in hypertensive patients in different MR pulse sequences and analyze the topography of CMBs visualized on gradient echo T_2~*-weighted imaging (GRE T_2~*-WI).Methods Two hundred and fifteen hypertensive patients (117 men and 98 women,(69.07±8.20) years old) were examined at 3.0T by using conventional and GRE T_2~*-WI sequences to detect numbers of CMBs.The numbers was compared among the sequences. The locations of the CMBs were categorized by cerebral region (cortico-subeortieal,basal ganglia,thalamus, brain stem and cerebellum) on GRE T_2~*-WI.Of the 215 patients,21 were examined by using the susceptibility weighted imaging (SWI).Results Of the 215 hypertensive patients,the median of CMBs detected were 2 on T_1WI(range,1 to 9),2 (1 to 18) on T_2WI,2 (1 to 13)on T_2Flair,2 (1 to 15) on DWI,and 2.5 (1 to 91) on GRE T_2~*-WI,respectively.The number of CMBs on GRE T_2~*-WI was significantly higher than that on the conventional MR sequences.On GRE T_2~*-WI,the numbers of CMBs was significantly higher in the cortico-subcortical region than in any of the other regions.The cerebellum had the lowest numbers of CMBs among all the regions examined.In 21 cases,267 and 215 CMBs were detected on SWI and GRE T_2~*-WI in the same coverage,respectively.Conclusions GRE T_2~*-WI could be the first choice of MR imaging sequence in diagnosing CMBs in hypertensive patients,with SWI as a supplementary one.