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Diagnostic value of lobar microbleeds in individuals without intracerebral hemorrhage.

Authors :
Martinez-Ramirez S
Romero JR
Shoamanesh A
McKee AC
Van Etten E
Pontes-Neto O
Macklin EA
Ayres A
Auriel E
Himali JJ
Beiser AS
DeCarli C
Stein TD
Alvarez VE
Frosch MP
Rosand J
Greenberg SM
Gurol ME
Seshadri S
Viswanathan A
Source :
Alzheimer's & dementia : the journal of the Alzheimer's Association [Alzheimers Dement] 2015 Dec; Vol. 11 (12), pp. 1480-1488. Date of Electronic Publication: 2015 Jun 13.
Publication Year :
2015

Abstract

Introduction: The Boston criteria are the basis for a noninvasive diagnosis of cerebral amyloid angiopathy (CAA) in the setting of lobar intracerebral hemorrhage (ICH). We assessed the accuracy of these criteria in individuals with lobar microbleeds (MBs) without ICH.<br />Methods: We identified individuals aged >55 years having brain magnetic resonance imaging (MRI) and pathological assessment of CAA in a single academic hospital and a community-based population (Framingham Heart Study [FHS]). We determined the positive predictive value (PPV) of the Boston criteria for CAA in both cohorts, using lobar MBs as the only hemorrhagic lesion to fulfill the criteria.<br />Results: We included 102 individuals: 55 from the hospital-based cohort and 47 from FHS (mean age at MRI 74.7 ± 8.5 and 83.4 ± 10.9 years; CAA prevalence 60% and 46.8%; cases with any lobar MB 49% and 21.3%; and cases with ≥2 strictly lobar MBs 29.1% and 8.5%, respectively). PPV of "probable CAA" (≥2 strictly lobar MBs) was 87.5% (95% confidence interval [CI], 60.4-97.8) and 25% (95% CI, 13.2-78) in hospital and general populations, respectively.<br />Discussion: Strictly lobar MBs strongly predict CAA in non-ICH individuals when found in a hospital context. However, their diagnostic accuracy in the general population appears limited.<br /> (Copyright © 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1552-5279
Volume :
11
Issue :
12
Database :
MEDLINE
Journal :
Alzheimer's & dementia : the journal of the Alzheimer's Association
Publication Type :
Academic Journal
Accession number :
26079413
Full Text :
https://doi.org/10.1016/j.jalz.2015.04.009