Loss on gradient-echo t2*-weighted mr images in patients with spontaneous intracerebral hemorrhage: evidence of microangiopathy-related microbleeds.

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Author	Fazekas, Franz Kleinert, Reinhold Roob, Gudrun Kleinert, Gertrude Kapeller, Peter Schmidt, Reinhold Hartung, Hans-Peter
Abstract	(ICH) frequently have small areas of signal loss on gradient-echo T2*-weighted MR images, which have been suggested to represent remnants of previous microbleeds. Our aim was to provide histopathologic support for this assumption and to clarify whether the presence and location of microbleeds were associated with microangiopathy. METHODS: We performed MR imaging and correlative histopathologic examination in 11 formalin-fixed brains of patients who had died of an ICH (age range, 45–90 years). RESULTS: Focal areas of signal loss on MR images were noted in seven brains. They were seen in a corticosubcortical location in six brains, in the basal ganglia/thalami in five, and infratentorially in three specimens. Histopathologic examination showed focal hemosiderin de-position in 21 of 34 areas of MR signal loss. No other corresponding abnormalities were found; however, hemosiderin deposits were noted without MR signal changes in two brains. All spec-imens with MR foci of signal loss showed moderate to severe fibrohyalinosis, and there was additional evidence of amyloid angiopathy in two of those brains. CONCLUSION: Small areas of signal loss on gradient echo T2*-weighted images indicate previous extravasation of blood and are related to bleeding-prone microangiopathy of different
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Subject Keyword	Signal Loss Microangiopathy-related Microbleeds Gradient-echo T2 Weighted Mr Image Spontaneous Intracerebral Hemorrhage Mr Image Small Area Mr Focus Mr Signal Loss Correlative Histopathologic Examination Additional Evidence Focal Hemosiderin De-position Amyloid Angiopathy Focal Area Formalin-fixed Brain Previous Extravasation Severe Fibrohyalinosis Gradient Echo T2 Previous Microbleeds Mr Signal Change Histopathologic Support Age Range Mr Imaging Corticosubcortical Location Histopathologic Examination Gradient-echo T2 Hemosiderin Deposit
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