脑微出血发病机制、流行病学、影像学表现及其临床意义

脑微出血（cerebral microbleeds，CMBs）属于脑小血管病（cerebral small vessel disease，CSVD） 的范畴，不同类型CSVD的发病机制、危险因素及其临床意义是不同的，诸多研究显示，CMBs已成为影 响卒中后出血转化、预后和复发、造成认知障碍以及年龄相关能力丧失的重要危险因素。CMBs与脑 出血联系紧密，可作为某些脑血管病的辅助诊断和出血预测指标，对其进行深入细致的研究，有助于 揭示CSVD的发生机制，对制定溶栓、抗凝、抗血小板等治疗方案具有重要的指导意义。因此，探讨 CMBs发病机制（包括基因遗传学、组织病理学）、早期预警及干预的手段是解决上述医学难题的关键。 本文重点对CMBs的定义及存在的争议、发病机制、流行病学、影像学表现及其临床意义进行综述分 析并提出研究展望，以期为CMBs的相关研究提供启示。

Pathogenesis,Epidemiology, Imaging Manifestations and Clinical Significance of Cerebral Microbleeds

Cerebral microbleeds (CMBs) belong to the category of cerebral small vessel disease (CSVD). The pathogenesis, risk factors and clinical significance of different types of CSVD are different. Many studies have shown that CMBs had become the important risk factors for influencing post-stroke hemorrhagic transformation, prognosis and recurrence, and causing cognitive impairment and loss of age-related ability. CMBs was closely associated with intracerebral hemorrhage, which could be used as some prediction indicators of the auxiliary diagnosis of cerebral vascular disease and bleeding. Further meticulous research on them can help to reveal the mechanism of CSVD, and have important guiding significance for thrombolysis, anticoagulant, antiplatelet and other treatment programs. Therefore, to explore the pathogenesis of CMBs (including genetic genetics, histopathology), early warning and intervention means is the key to solve the above-mentioned medical problems. In this paper, the definition and controversy, pathogenesis, epidemiology, imaging manifestations and clinical significance of CMBs were reviewed and the prospect of the research was also raised so as to provide enlightment for CMBs related studies.