Cerebral Microbleeds on MR Imaging: Comparison between 1.5 and 7T

BACKGROUND AND PURPOSE: The detection of microbleeds differs strongly between studies, due to differences in scan protocol. This study aims to compare the visualization of microbleeds with 3D T2*-weighted imaging at 1.5T with 3D dual-echo T2*-weighted imaging at 7T. MATERIALS AND METHODS: Thirty-four patients (29 male; mean age, 58 ± 12 years) with atherosclerotic disease from the Second Manifestations of ARTerial Disease study were included. 3D T2*-weighted imaging at 1.5T and dual-echo T2*-weighted imaging at 7T were done in all patients. The presence and number of definite microbleeds were recorded on minimal intensity projections. Inter- and intraobserver reliability was assessed with Cohen κ test and the ICC. The difference in presence and number of microbleeds was tested with the McNemar test and Wilcoxon signed rank test. RESULTS: The interobserver ICC at 7T was 0.61 and the intraobserver ICC was 0.94, whereas at 1.5T the interobserver ICC was 0.50 and the intraobserver ICC was 0.59. Microbleeds were detected in significantly more patients on 7T (50%) than on 1.5T scans (21%) (P = .001). The number of microbleeds was also higher at 7T (median, 0.5; range, 0–5) than on 1.5T (median, 0.0; range, 0–6) (P = .002). CONCLUSIONS: 3D dual-echo T2*-weighted imaging at 7T results in better and more reliable detection of microbleeds compared with 3D T2*-weighted imaging at 1.5T.

[1]  Peter R Luijten,et al.  Visualization of cerebral microbleeds with dual‐echo T2*‐weighted magnetic resonance imaging at 7.0 T , 2010, Journal of magnetic resonance imaging : JMRI.

[2]  D. Werring,et al.  Brain microbleeds as a potential risk factor for antiplatelet-related intracerebral haemorrhage: hospital-based, case–control study , 2010, Journal of Neurology, Neurosurgery & Psychiatry.

[3]  D. Werring,et al.  The Microbleed Anatomical Rating Scale (MARS) , 2009, Neurology.

[4]  M. Breteler,et al.  CEREBRAL MICROBLEED PRECEDING SYMPTOMATIC INTRACEREBRAL HEMORRHAGE IN A STROKE-FREE PERSON , 2009, Neurology.

[5]  Steven Warach,et al.  Cerebral Microbleeds : A Field Guide to their Detection and Interpretation , 2012 .

[6]  Frederik Barkhof,et al.  MRI Biomarkers of Vascular Damage and Atrophy Predicting Mortality in a Memory Clinic Population , 2009, Stroke.

[7]  Joanna M Wardlaw,et al.  Improving Interrater Agreement About Brain Microbleeds: Development of the Brain Observer MicroBleed Scale (BOMBS) , 2009, Stroke.

[8]  E. Haacke,et al.  Susceptibility-Weighted Imaging: Technical Aspects and Clinical Applications, Part 1 , 2008, American Journal of Neuroradiology.

[9]  Eric E. Smith,et al.  MR Imaging Detection of Cerebral Microbleeds: Effect of Susceptibility-Weighted Imaging, Section Thickness, and Field Strength , 2008, American Journal of Neuroradiology.

[10]  E. Haacke,et al.  Serial susceptibility weighted MRI measures brain iron and microbleeds in dementia. , 2009, Journal of Alzheimer's disease : JAD.

[11]  H. Leung,et al.  Risk vs benefit of anti-thrombotic therapy in ischaemic stroke patients with cerebral microbleeds , 2008, Journal of Neurology.

[12]  Jeroen Hendrikse,et al.  Noninvasive Depiction of the Lenticulostriate Arteries with Time-of-Flight MR Angiography at 7.0 T , 2008, Cerebrovascular Diseases.

[13]  Hidenao Fukuyama,et al.  Microbleeds in Moyamoya Disease: Susceptibility-Weighted Imaging Versus T2*-Weighted Imaging at 3 Tesla , 2008, Investigative radiology.

[14]  P. Kirchhof,et al.  Detection of asymptomatic cerebral microbleeds: a comparative study at 1.5 and 3.0 T. , 2008, Academic radiology.

[15]  Aad van der Lugt,et al.  Cerebral microbleeds: accelerated 3D T2*-weighted GRE MR imaging versus conventional 2D T2*-weighted GRE MR imaging for detection. , 2008, Radiology.

[16]  Aad van der Lugt,et al.  Risk of thrombolysis-related hemorrhage associated with microbleed presence. , 2008, Stroke.

[17]  Zhaoyang Jin,et al.  Simultaneous acquisition of MR angiography and venography (MRAV) , 2008, Magnetic resonance in medicine.

[18]  T. Ayaki,et al.  Type of Gradient Recalled-Echo Sequence Results in Size and Number Change of Cerebral Microbleeds , 2008, American Journal of Neuroradiology.

[19]  C. Cordonnier [Brain microbleeds]. , 2008, Revue neurologique.

[20]  T. Murakami,et al.  T2*-sensitized high-resolution magnetic resonance venography using 3D-PRESTO technique. , 2008, Magnetic resonance in medical sciences : MRMS : an official journal of Japan Society of Magnetic Resonance in Medicine.

[21]  T. Neumann-Haefelin,et al.  Bleeding Risk Analysis in Stroke Imaging Before ThromboLysis (BRASIL): Pooled Analysis of T2*-Weighted Magnetic Resonance Imaging Data From 570 Patients , 2007, Stroke.

[22]  J. Jeret Prevalence and severity of microbleeds in a memory clinic setting , 2007, Neurology.

[23]  Aad van der Lugt,et al.  O3-04-07 Prevalence and risk factors of cerebral microbleeds in the Rotterdam scan study , 2006, Alzheimer's & Dementia.

[24]  Yingbiao Xu,et al.  The role of voxel aspect ratio in determining apparent vascular phase behavior in susceptibility weighted imaging. , 2006, Magnetic resonance imaging.

[25]  H. Koennecke Cerebral microbleeds on MRI , 2006, Neurology.

[26]  M. Dennis,et al.  Cerebral Microbleeds Are Associated With Lacunar Stroke , 2006 .

[27]  K. Nozaki,et al.  Asymptomatic microbleeds in moyamoya disease: T2*-weighted gradient-echo magnetic resonance imaging study. , 2005, Journal of neurosurgery.

[28]  Rhoda Au,et al.  Cerebral Microbleeds: Prevalence and Associations With Cardiovascular Risk Factors in the Framingham Study , 2004, Stroke.

[29]  D. Werring,et al.  Cognitive dysfunction in patients with cerebral microbleeds on T2*-weighted gradient-echo MRI. , 2004, Brain : a journal of neurology.

[30]  A. Algra,et al.  Second Manifestations of ARTerial disease (SMART) study: Rationale and design , 1999, European Journal of Epidemiology.

[31]  Nils Peters,et al.  Cerebral Microbleeds in CADASIL: A Gradient-Echo Magnetic Resonance Imaging and Autopsy Study , 2002, Stroke.

[32]  P Kapeller,et al.  Histopathologic analysis of foci of signal loss on gradient-echo T2*-weighted MR images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds. , 1999, AJNR. American journal of neuroradiology.

[33]  P Kapeller,et al.  MRI evidence of past cerebral microbleeds in a healthy elderly population , 1999, Neurology.

[34]  J. Reichenbach,et al.  Theory and application of static field inhomogeneity effects in gradient‐echo imaging , 1997, Journal of magnetic resonance imaging : JMRI.

[35]  J. Duyn,et al.  A. functional MRI technique combining principles of echo‐shifting with a train of observations (PRESTO) , 1993, Magnetic resonance in medicine.

[36]  W. Bradley MR appearance of hemorrhage in the brain. , 1993, Radiology.

[37]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.