Distribution Analysis of Cerebral Microbleeds in Alzheimer's Disease and Cerebral Infarction with Susceptibility Weighted MR Imaging

Abstract

Background Cerebral microbleeds (CMBs) reflect cerebral small vessel disease and has a pathological role in Alzheimer's disease (AD) and stroke according to their distribution. We investigated to determine whether association of CMBs distribution in Korean patients with AD and cerebral infarction by susceptibility weighted imaging (SWI) which is a most sensitive magnetic resonance imaging technique for enhanced detection and localization of CMBs. Methods Seventy-one patients (AD 30, recent cerebral infarction 21, control 20) were included and 1.5 Tesla SWI was used to image. The Microbleed Anatomical Rating Scale (MARS) was used to localize each CMBs distribution (lobar versus basal ganglia/thalamus [deep], and infratentorial). Results The prevalence of CMBs was higher in AD and cerebral infarction than controls (p=0.004). Predilection of the total CMBs (n=71) were in order of lobar, basal ganglia/thalamus (deep), and infratentorial region (p=0.029). There was only significant predilection of CMBs in basal ganglia/thalamus (deep) region in cerebral infarction compared with AD (p=0.037) and controls (p=0.011). However, predilection of CMBs in lobar region than infratentorial region (p=0.019) in AD, and predilection of CMBs in basal ganglia/thalamus (deep) region than infratentorial region (p=0.033) in cerebral infarction were significant. Hypertension, a strong risk factor for hypertensive angiopathy was not significant in contributing CMBs prevalence in three groups even though the incidence of hypertension was higher in cerebral infarction than AD and controls. Conclusion Characteristic predilection pattern of CMBs distribution between AD and cerebral infarction through SWI might provide an imaging biomarker for differentiation between dementia due to cerebrovascular disease and cerebral degenerative disorders. Key Words: Cerebral microbleeds, Susceptibility weighted imaging, Alzheimer’s disease, Cerebral infarction