无症状脑微出血

Asymptomatic Cerebral Microbleeds

脑微出血(cerebral microbleed,CMB)表现为在梯度回波T2加权MPI(GE-MRI)上均匀一致的卵圆形T2信号减低区。8％-66％的脑出血(ICH)患者、21％-26％的缺血性卒中患者和5％-6％的正常老年人可检出CMB。CMB可能与易于出血的微血管病相关。CMB患者发生ICH的危险性较高,在卒中治疗时应加以考虑。溶栓治疗时,MRI检查有无CMB有很重要的价值。CMB可预测再发性ICH、抗凝后ICH或抗血小板治疗预防缺血性卒中时出现的ICH等并发症,还有助于评估淀粉样脑血管病的病程进展情况。

Cerebral microbleeds (CMBs) present as well-distributed, oval, silent foci of signal loss visualized on gradient-echo T2-weighted MRI (GE-MRI) sequences. CMBs can be found in 8% to 66% of patients with intracerebral hemorrhage (ICH), 21 % to 26% of patients with ische-mic stroke and 5% to 6% of healthy elder individuals. CMBs may be related with bleeding-prone microangiopathy. Patients with CMBs have higher risk of ICH, and this should be considered during the treatment of stroke. It has important value in evaluating CMBs by MRI during thrombolytic therapy. CMBs can predict the reoccurrence of ICH and ICH occurred after thrombolytic therapy or complications (such as ICH) after antiplatelet therapy during the secondary prevention of is-chemic stroke, and it also helpful in evaluating the progression of cerebral amyloid angiopathy.