High incidence of microbleeds in hemodialysis patients detected by T2*-weighted gradient-echo magnetic resonance imaging

The incidence and characteristics of microbleeds in hemodialysis (HD) patients were investigated to elucidate the clinical significance with T-2*-weighted gradient-echo magnetic resonance (MR) imaging. The 57 patients with chronic renal failure maintained by HD had no previous history of stroke. The control group consisted of 53 patients without previous history of stroke or chronic renal failure. The incidence and the number of microbleeds were assessed in the HD and control groups. The findings of microbleeds with T-2*-weighted gradient-echo MR imaging were compared with those of T-1- and T-2-weighted MR imaging in HD patients. The incidence of microbleeds was significantly greater in the HD patients compared with the control patients. T-2*-weighted gradient-echo imaging revealed a total of 44 microbleeds in 11 HD patients. T2-weighted imaging demonstrated 13 of 44 microbleeds as hyperintensity, whereas T-1-weighted imaging demonstrated 12 lesions as hypointensity. T-2- and T-1-weighted imagings did not demonstrate any findings in 31 and 32 lesions, respectively. T2*-weighted gradient-echo MR imaging is effective to detect microbleeds which may be a predictor of intracerebral hemorrhage in HD patients and should be included in the protocol for the study of cerebrovascular disease, because T-2- and T-1-weighted MR imaging recognizes microbleeds as lacunar infarction.