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DOI: 10.1055/s-0042-118770
Zerebrale Mikroblutungen: Bildgebung, Ursachen und Differenzialdiagnosen
Cerebral microbleeds: imaging characteristics, causes and differential diagnosesPublication History
Publication Date:
06 December 2016 (online)
![](https://www.thieme-connect.de/media/rad-u2d/201604/lookinside/thumbnails/278_10-1055-s-0042-118770-1.jpg)
Zusammenfassung
Zerebrale Mikroblutungen (ZMB) sind kleinste Hämosiderinablagerungen im Hirnparenchym, die auf suszeptibilitätsempfindlichen MRT-Sequenzen als kleine, rundliche bis ovale Signalauslöschungen zu erkennen sind. Diese Übersichtsarbeit fasst methodische Aspekte zusammen, die helfen, ZMB sicher zu identifizieren und von anderen Ursachen fokaler Hypointensitäten in diesen Sequenzen abzugrenzen. Wichtige Differenzialdiagnosen und Imitatoren („mimics“) werden vorgestellt. Darüber hinaus wird die klinische Bedeutung der ZMB diskutiert, insbesondere ihre Rolle als MRT-Marker verschiedener zerebraler Mikroangiopathien.
Abstract
Cerebral microbleeds (CMB) represent small hemosiderin deposits, which are surrounded by normal brain tissue and can be depicted as small, rounded or ovoid areas of signal loss on susceptibility-sensitive MRI sequences. This review summarizes helpful methodological considerations to identify CMBs and to differentiate them from other causes of focal hypointensities on these sequences. Important differential diagnoses and „mimics“ are presented and the clinical relevance of CMBs is discussed, in particular their role as important MRI marker of various cerebral small vessel diseases.
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Zerebrale Mikroblutungen (ZMB) finden sich bei älteren Patienten und auch in der asymptomatischen älteren Allgemeinbevölkerung in suszeptibilitätsgewichteten MRT-Sequenzen häufig.
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ZMB zeigen eine gewisse erhöhte Blutungsneigung des Hirngewebes an, weshalb ihre Bedeutung als Risikofaktor symptomatischer Hirnblutungen aktuell intensiv beforscht wird.
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Für den Radiologen sind die ZMB vor allem als MRT-Marker verschiedener zerebraler Mikroangiopathien wichtig.
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Konsensuskriterien sind hilfreich, um ZMB von Artefakten und Imitatoren („mimics“) zu unterscheiden.
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