Role of T2* GRE MRI Sequence in Detecting Cerebral Microbleeds in Hypertensive Patients Presenting with Intra Cerebral Hemorrhage

Abstract

OBJECTIVES Examine the efficacy of T2* gradient echo in detecting Cerebral microbleeds (CMBs) among hypertensive patients, emphasizing its efficiency in acquisition time. Evaluate its potential as an alternative to susceptibility-weighted imaging (SWI) in routine assessments for hypertensive individuals. METHODOLOGY A cross-sectional study from Sep 2021 to January 2023 was conducted at the Radiology Unit of Lady Reading Hospital Peshawar. Patients suspected of having a cerebrovascular accident (CVA) were referred from different units who had proven Intracerebral hemorrhage (ICH) on initial CT brain. The exclusion criteria were a history of recent trauma aneurysms/tumors on the present scan. The MRI examination included sequences like T1, T2, FLAIR, DWI/ADC, and T2*. The CMB was defined as a hypointense focus of signal drops out, measuring 5-10mm, with blooming artefact on T2* images and no surrounding edema. RESULTS 62 patients were included in the study, with an equal proportion of males and females and age ranges between 46 to 78 years (62 ± 4.7). Forty-one cases had CMBs on T2* sequence in these 62 cases (66%), and 18 (44%) cases out of 41 were visible on T2WI. No significant correlation was seen between grades of CMBs and the location or size of the microbleed on Spearman’s test. CONCLUSION T2*GRE weighting can effectively detect CMBs compared to SWI. Therefore, this sequence could be employed in hospitals with increased workloads due to short acquisition time instead of the longer time for SWI.

Keywords

• Intracerebral hemorrhage (ICH)
• Cerebral microbleeds (CMBs)
• Hypertension
• T2*gradient echo MRI
• Susceptibility weighted images (SWI)