, Volume 61, Issue 10, pp 1209–1213 | Cite as

MRI detection of cerebral microbleeds: size matters

  • Sven HallerEmail author
  • Max Scheffler
  • Rares Salomir
  • François R. Herrmann
  • Gabriel Gold
  • Marie-Louise Montandon
  • Enikö Kövari
Short Report



Cerebral microbleeds (CMB) play an important role as an imaging biomarker notably in vascular and neurodegenerative diseases. Current clinical brain MRI underestimates the number of CMB with respect to histopathology. It is expected that small CMBs are more likely to be false-negatives, yet this has not been demonstrated and the average size of false-negative and true-positive CMBs have not been established.


The radiologic-histopathologic correlation study was approved by the local review board and included 42 consecutive cases (mean age at death, 80.7 ± 10.0 years; 23 females and 19 men) between 12 January 2012 and 10 December 2012 having undergone brain autopsy. Postmortem SWI (susceptibility-weighted imaging) images were acquired on a clinical 3T system using parameters similar to clinical routine. The detection of CMB on postmortem MRI was compared with corresponding histopathological slices.


Postmortem MRI detected 23 true-positive CMB. Histopathology additionally detected 68 CMBs (false-negative MRI CMBs). The average size true-positive MRI CMBs had on histopathology was 3.6 ± 7.1 mm3. The average size false-negative MRI CMBs was significantly smaller (p < 0.05), measuring 0.3 ± 1.2 mm3 on histopathology.


Size matters. As expected, the average size of true-positive MRI CMB was around 10 times larger as compared with false-negative MRI CMB. Evidently, in addition to size, other factors will influence the detectability of CMB, including iron content, ratio of Fe2+/Fe3+, spatial configuration, and location, yet this remains to be elucidated in future studies.


Microbleeds MRI Pathology Dementia 



The authors would like to thank Mrs. P. Lovero, Mr. E. Maturana and all collaborators of the Unit of Radiology at the Geriatric Hospital for their expert technical assistance.


This work was supported by Swiss National Foundation Grant SNF 320030_159990.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was waived by the IRB.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Faculty of MedicineUniversity of GenevaGenevaSwitzerland
  2. 2.Department of Surgical Sciences, RadiologyUppsala UniversityUppsalaSweden
  3. 3.Department of RadiologyUniversity Hospitals of GenevaGenevaSwitzerland
  4. 4.Department of Rehabilitation and GeriatricsUniversity Hospitals of GenevaGenevaSwitzerland
  5. 5.Department of PsychiatryUniversity Hospitals of GenevaGenevaSwitzerland

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