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Cerebral Microbleeds: Imaging and Clinical Significance
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Affidea Centre de Diagnostic Radiologique de Carouge, Geneva, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland; Department of Neuroradiology, University Hospital Freiburg, Freiburg, Germany .ORCID iD: 0000-0001-7433-0203
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology.ORCID iD: 0000-0001-6308-1387
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2018 (English)In: Radiology, ISSN 0033-8419, E-ISSN 1527-1315, Vol. 287, no 1, p. 11-28Article in journal (Refereed) Published
Abstract [en]

Cerebral microbleeds (CMBs), also referred to as cerebral microhemorrhages, are small hypointense foci with a maximum size up to 5 mm or even 10 mm detected by using susceptibility-weighted (SW) magnetic resonance (MR) imaging (1–5). Histopathologically, CMBs represent focal accumulations of hemosiderin-containing macrophages (6) with paramagnetic properties causing signal loss because of susceptibility effects. Because of the increasing use of high-field-strength MR imaging systems and dedicated imaging sequences—notably, three-dimensional T2*-weighted imaging, SW imaging, and related techniques—CMBs are increasingly depicted during MR imaging of the brain. CMBs may be observed as an incidental finding or in the context of a specific pathologic finding such as cerebral amyloid angiopathy (CAA). Despite the increased detection rate, clear guidance for radiologists for the interpretation of CMBs are currently lacking and their clinical significance remains controversial.

The sensitivity of MR imaging to depict microbleeds depends on technical aspects, for example, field strength and pulse-sequence parameters. To allow correct depiction of CMBs, we first discuss the optimal MR imaging technique. Once a potential CMB is observed, correct classification requires knowledge about pathologic correlations and potential CMB “mimics,” which we address in the next section. Then, we review the interpretation of CMBs in various clinical situations and diseases, such as aging, dementia, radiation therapy, and traumatic brain injury. Finally, we discuss the clinical significance of CMBs in stroke and the clinical management of CMBs.

Place, publisher, year, edition, pages
2018. Vol. 287, no 1, p. 11-28
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Radiology, Nuclear Medicine and Medical Imaging
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URN: urn:nbn:se:uu:diva-346992DOI: 10.1148/radiol.2018170803ISI: 000427992600003PubMedID: 29558307OAI: oai:DiVA.org:uu-346992DiVA, id: diva2:1192656
Available from: 2018-03-23 Created: 2018-03-23 Last updated: 2018-04-12Bibliographically approved

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Haller, SvenLarsson, Elna-Marie

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