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Radiologic-Histopathologic Correlation of Cerebral Microbleeds Using Pre-Mortem and Post-Mortem MRI
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Radiology. Affidea Ctr Diagnost Radiol Carouge CDRC, Carouge, Switzerland.; Med Sch Univ, Geneva, Switzerland.; Univ Hosp Freiburg, Dept Neuroradiol, Freiburg, Germany. .
Med Sch Univ, Geneva, Switzerland.
Univ Geneva, Dept Mental Hlth & Psychiat, Geneva, Switzerland.
Univ Geneva, Dept Mental Hlth & Psychiat, Geneva, Switzerland.
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2016 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 11, no 12, article id e0167743Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Cerebral microbleeds (CMB), also known as cerebral microhemorrhages, are small areas of susceptibility on brain magnetic resonance imaging (MRI), that are increasingly detected due to the higher availability of high-field MRI systems and dedicated pulse sequences. The prevalence of CMBs increases in cases with cognitive decline. The current investigation assessed the poorly investigated radiologic-histopathologic correlation of CMBs on MRI.

METHODS: The local ethical committee approved the current investigation. We retrospectively assessed a consecutive series of 1303 autopsy cases hospitalized in Geneva University Hospitals between 2000-2014. Of 112 cases with pre-mortem T2* sequences, we included 25 cases (mean age 77.3 ± 9.6, 9 females) with at least one CMB. We compared pre-mortem CMBs with targeted histopathology and post-mortem MRI.

RESULTS: 25 cases had 31 CMB lesions detected by pre-mortem MRI. 25 additional CMB were detected on histopathology. 4 CMBs on pre-mortem MRI were false positives, resulting in a total of 52 CMBs. 27 CMBs on pre-mortem MRI were confirmed on histopathology, corresponding to a sensitivity or true positive rate of 51.9% (95% CI 37.6-66.0%). The false negative rate of pre-mortem MRI was 48.1% (95% CI 34.0-62.4%). Post-mortem MRI showed only 3 cases with additional CMBs. Overall, pre-mortem MRI significantly underestimated CMBs (p = 0.0001).

CONCLUSIONS: Routine clinical brain MRI underestimates the prevalence of CMBs by approximately 50%, and 12% of radiologic pre-mortem MRI CMBs were false positives. Post-mortem MRI confirmed that this discordance is not explained by microbleeds occurring after the pre-mortem MRI.

Place, publisher, year, edition, pages
2016. Vol. 11, no 12, article id e0167743
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Radiology, Nuclear Medicine and Medical Imaging
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URN: urn:nbn:se:uu:diva-312286DOI: 10.1371/journal.pone.0167743ISI: 000389587100171PubMedID: 27936213OAI: oai:DiVA.org:uu-312286DiVA, id: diva2:1062973
Available from: 2017-01-09 Created: 2017-01-09 Last updated: 2017-11-29Bibliographically approved

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