Completed
aasim
ANATOMY
Dec 19, 2025
Authors: Raja Faisal1, Shahid Kamran2, Shahid Maqbool Korai3, Sadia Sundus4, Sadia Javaid5Amanullah Khokhar6
DOI: https://doi.org/10.36552/pjns.v29i1.1027
Keywords: leukoariosis, fazekas, Intracerebral bleed, microbleed anatomical rating scale, stroke
Abstract
Objectives: Using Fazekas and Micro-bleed Anatomical Rating Scales (MARS) to assess the inter-relationship of MB(C) and leukoaraiosis based on magnetic resonance imaging (MRI).
Materials and Methods: Cross-sectional observational research was carried out at the radiology department of RYK Hospital Rahim Yar Khan, Pakistan. The study involved 70 participants who had MRI brain scans and were discovered to have micro-bleeds. The Micro-bleed Anatomical Rating scale (MARS) was used to grade micro-bleeds and Fazeka’s scale was implied for grading leukoaraiosis. The relationship between MARS and Fazeka’s scale was ascertained by Spearman's correlation.
Results: The patient's mean age was 65 years and 2 months, with male to female gender ratio of 1.8:1. A significant correlation (p<0.001) was observed between micro-bleeds grading of MARS and Fazekas grades, with a significant correlation coefficient of 1. Cerebral micro-bleeds also correlated with coexisting diseases, notably hypertension (84.28%), diabetes (60.00%), and smoking (55.71%). MRI analysis showed micro-bleeds were most frequently in variable locations (44.6%), followed by lobar regions (27.7%), deeper areas (18.5%), and basal nuclei (9.2%).
Conclusion: Leukoaraiosis (LA) and MB(C) have a strong correlation that suggests micro-blood vessel ischemia and hemorrhage as ultimate outcomes.
References
Jiang M, Wu S, Zhang Y, Li Y, Lin B, Pan Q, Tian S, Ni R, Liu Q, Zhu Y. Impact of White Matter Hyperintensity and Age on Gait Parameters in Patients with Cerebral Small Vessel Disease. J Am Med Dir Assoc. 2023;24(5):672-678.
DOI: 10.1016/j.jamda.2022.12.001
Oussoren FK, Van Leeuwen RB, Schermer TR, Poulsen LNF, Kardux JJ, Bruintjes TD. Cerebral Small Vessel Disease in Elderly Patients with Sudden Sensorineural Hearing Loss. Otol Neurotol. 2023 1;44(3):e171-e177.
DOI: 10.1097/MAO.0000000000003813.
Aman M, Alam MS, Khan FU, Anwar SS, Ahmad A, Khan U, Bazai UK. High-altitude cerebral edema manifesting as T2/FLAIR hyperintensity and microbleeds in the white matter on MRI brain. Radiol Case Rep. 2023;18(5):1705-1709.
DOI: 10.1016/J.RADCR.2023.01.071
Jin P, Ye S, Ye H, Tong Q, Zhang Q. Urinary microalbumin/creatinine ratio is a predictor of the occurrence and severity of leukoaraiosis. Neuro Endocrinol Lett. 202312;44(8):528-536. PMID: 38131176. https://pubmed.ncbi.nlm.nih.gov/38131176/
Chen TY, Chan PC, Tsai CF, Wei CY, Chiu PY. White matter hyperintensities in dementia with Lewy bodies are associated with poorer cognitive function and higher dementia stages. Front Aging Neurosci. 2022 26;14:935652.
DOI: 10.3389/fnagi.2022.935652.
Khan S, Siddiqui M, Kamal AK. My patient's brain MRI has cerebral microbleeds—what does this finding mean? J Pak Med Assoc. 2011;61(10):1029-1030.
Wu B, Huang D, Yi Z, Yu F, Liu L, Tang X, Jing K, Fan J, Pan C. Correlation between body composition and white matter hyperintensity in patients with acute ischemic stroke. Medicine (Baltimore). 2023;15;102(50):e36497. DOI: 10.1097/MD.0000000000036497.
Cedres N, Ferreira D, Machado A, Shams S, Sacuiu S, Waern M et al. Predicting Fazekas scores from automatic segmentations of white matter signal abnormalities. Aging (Albany NY). 2020;12;12(1):894-901.
DOI: 10.18632/aging.102662.
Evlice A, Sanli ZS, Boz PB. The importance of Vitamin-D and Neutrophil-Lymphocyte Ratio for Alzheimer's Disease. Pak J Med Sci. 2023;39(3):799-803. DOI: 10.12669/pjms.39.3.7024.
Yamada S, Saiki M, Satow T, Fukuda A, Ito M, Minami S, et al. Periventricular and deep white matter leukoaraiosis have a closer association with cerebral micro-bleeds than age. Eur J Neurol. 2012;19(1):98-104.
Doi: 10.1111/j.1468-1331.2011.03451.x.
Masuadi E, Mohamud M, Almutairi M, Alsunaidi A, Alswayed AK, Aldhafeeri OF. Trends in the Usage of Statistical Software and Their Associated Study Designs in Health Sciences Research: A Bibliometric Analysis. Cureus. 2021;11;13(1):e12639. DOI: 10.7759/cureus.12639.
Yang Q, Yang Y, Li C, Li J, Liu X, Wang A, et al. Quantitative assessment and correlation analysis of cerebral microbleed distribution and leukoaraiosis in stroke outpatients. Neurological Research. 2015;37(5):403-09.
DOI: 10.1179/1743132815Y.0000000027
Samanvitha G and Ananad K. Correlation between Cerebral Microbleeds and White Matter Changes on MRI using Microbleed Anatomical Rating and Fazekas Scales: A Cross-sectional Study. International Journal of Anatomy, Radiology and Surgery. 2024;13(1): 01-05.
DOI: 10.7860/IJARS/2024/66333.2962.
Haller S, Vernooij MW, Kuijer JPA, Larsson EM, Jäger HR, Barkhof F. Cerebral micro-bleeds: Imaging and clinical significance. Radiology. 2018;287(1):11-28.
DOI: 10.1148/radiol.2018170803.
Liu W, Liu R, Sun W, Peng Q, Zhang W, Xu E, et al. CASISP Study Group. Different impacts of blood pressure variability on the progression of cerebral micro-bleeds and white matter lesions. Stroke. 2012;43(11):2916-22.
DOI: 10.1161/STROKEAHA.112.658369.
Pingping H, Rui J, Jianhao L, Peng W, Feizhou D. Risk factors of cerebral microbleeds in young and middle-aged hypertensive patients. Neurol Asia. 2021;26(4):688-94. Doi: 10.54029/2021yny.