Keywords
T2* gradient echo
cerebral microhaemorrhages
haemosiderin
cerebral microvascular disease
How to Cite
Abstract
Introduction The aim of the study was to assess the usefulness of T2* gradient echo (T2* GRE) in magnetic resonance imaging (MRI) for the detection of cerebral microhaemorrhages, considering its high sensitivity to the magnetic susceptibility effects produced by paramagnetic substances such as haemosiderin. The relevance of MRI as a non-invasive diagnostic method free of ionising radiation was highlighted, especially in view of the limitations of computed tomography in identifying microscopic haemorrhagic lesions. Development Throughout the development, the anatomical, physiological, and pathophysiological foundations of the brain and cerebral microcirculation were described, establishing the relationship between microvascular disease and the appearance of cerebral microhaemorrhages. The role of the T2* GRE sequence in the visualisation of haemosiderin deposits, which manifested as hypointense punctiform foci smaller than 10 mm, was analysed. Likewise, the main associated aetiologies were identified, including arterial hypertension, cerebral amyloid angiopathy, haematological disorders, the use of anticoagulants and degenerative diseases. Its clinical importance was highlighted in vulnerable populations, such as paediatric patients, where pathologies such as leukaemia with hyperleukocytosis increased the risk of thrombosis and cerebral haemorrhage. Conclusion It was concluded that the GRE T2* sequence was an essential diagnostic tool for the early detection and evolutionary characterisation of cerebral microhaemorrhages. Its systematic incorporation into cerebral MRI protocols provided relevant information for clinical decision-making, improving the assessment of haemorrhagic risk and contributing to the prevention of serious neurological complications.
References
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36. Voorter PHM, van Dinther M, Jansen WJ, Postma AA, Staals J, Jansen JFA, et al. Blood–Brain Barrier Disruption and Perivascular Spaces in Small Vessel Disease and Neurodegenerative Diseases: A Review on MRI Methods and Insights. Journal of Magnetic Resonance Imaging 2024;59:397–411. https://doi.org/10.1002/jmri.28989.
37. Wan S, Dandu C, Han G, Guo Y, Ding Y, Song H, et al. Plasma inflammatory biomarkers in cerebral small vessel disease: A review. CNS Neuroscience and Therapeutics 2023;29:498–515. https://doi.org/10.1111/cns.14047.
38. Wang S, Zhang F, Huang P, Hong H, Jiaerken Y, Yu X, et al. Superficial white matter microstructure affects processing speed in cerebral small vessel disease. Human Brain Mapping 2022;43:5310–25. https://doi.org/10.1002/hbm.26004.
39. Xiao Y, Teng Z, Xu J, Qi Q, Guan T, Jiang X, et al. Systemic Immune-Inflammation Index is Associated with Cerebral Small Vessel Disease Burden and Cognitive Impairment. Neuropsychiatric Disease and Treatment 2023;19:403–13. https://doi.org/10.2147/NDT.S401098.
40. Zhang M, Tang J, Xia D, Xue Y, Ren X, Huang Q, et al. Evaluation of glymphatic-meningeal lymphatic system with intravenous gadolinium-based contrast-enhancement in cerebral small-vessel disease. European Radiology 2023;33:6096–106. https://doi.org/10.1007/s00330-023-09796-6.
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Copyright (c) 2023 María José Rojas Fuentes, Rodrigo Andrés Valenzuela Muñoz, João Pedro Almeida Santos, Carlos Eduardo Ramírez Álvarez (Author)