Assessment Of The Effect Of Antithrombotic Drugs On Cerebral Microbleeds In Patients With Cerebral Infarction Using ESWAN

Objective: The aims of this study were to evaluate the role of three-dimensional(3D)-enhanced T2*-weighted angiography(ESWAN)in diagnosing the cerebral microbleeds in(CBMs),and examine the association between antithrombotic drug treatment and the presence of CMBs in patients with cerebral infraction using general Sequences in head Magnetic Resonance Imaging(MRI)and ESWAN.Method: The study was performed among 86 patients(67.16 ± 9.26 years,51 males,35 females)with brain infarction diagnosed by head MRI general check(T1-weighted imaging(T1WI),and T2-weighted imaging(T2WI),and T2-fluid attenuated inversion recover(T2Flair)and the Diffusion Weighted imaging(DWI)sequence.MRI and the ESWAN sequence check were then applied to assess the presence and features of CMBs.Based on the collected complete clinical information on inpatient or outpatient usage of anti-platelet drugs before MRI,the patients were then further divided into two groups: patients who reported previous antiplatelet therapy(n=38)and patients who did not(n=48).The relations between the clinic conditions(antiplatelet medication,Hypertension,D-dimer,PT,urine protein,stroke history,etc)and the presence of CMBs were then analyzed via SPSS 20.0 methods.In addition,according to whether the cerebral infarction patients accompanied with CMBs group,the 86 cases were divided into CMBs Group(CMBs(+))(n=58)and no CMBs Group(CMBs(-)Group)(n=28),analyzing clinical risk factors of CMBs.Result: ESWAN sequence detected altogether 351 number of CMBs,T1 WI sequence detected 60,the detection rate was 17.09%,T2 WI sequence detected 82,the detection rate was 23.36%,T2 Flair sequence detected 96,the detection rate was 27.35%,DWI sequence detected 72,the detection rate was 20.51%,it is significant difference between the detection of these sequences(p <0.05).Compared with patients without previous antiplatelet treatment history,the incidence and prevalence rate of CMBs were more significant among patients with previous antiplatelet treatment,Moreover,in the brain stem and cerebellum range,the size of CMBs are higher,the number of CMBs are also significantly higher in the groups of patients with previous antiplatelet drug treatment(p<0.05).The proportion of hypertension,d-dimer,PT,urine protein,history of stroke,anti-platelet and NHISS scores with CMBs group were significantly higher than no CMBs Group(p<0.05).By multivariate logistic regression analysis,the elderly age(OR 1.100,95%CI1.022to1.184,P=0.012)and the history of stroke(OR0.079,95% CI0.013to0.479,P=0.006)independently predicted the occurrence of the CMBs Group.Conclusion: This study proves the significant clinic value of ESWAN in detecting CMBs.The occurrence of CMBs of patients using anti-platelet drugs with cerebral infraction increased significantly,especially the higher prevalence in the brainstem and cerebellum areas.Multi factors could affect the presence of CMBs.Among them,old age and history of stroke are independently related to the presence of CMBs.