MR Imaging of Cerebral Hematomas at Different Field Strengths

Ra, Brooks; G, Di Chiro; Patronas, N J

doi:10.1097/00004728-198903000-00002

Cited by 71 publications

(48 citation statements)

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“…This hypointensity has been attributed to the magnetic field inhomogeneity caused by paramagnetic intracellular deoxyhemoglobin in acute hematoma (1, 2, 16, 23, 24) and paramagnetic intracellular methemoglobin in early subacute hematoma (1, 23). Does et al (25) and Schaefer et al (26) reported that magnetic susceptibility effects caused a drop in ADC, and suggested that an accurate ADC value for acute and early subacute hematomas could not be reliably calculated.…”

Section: Discussionmentioning

confidence: 99%

“…We believe that variations in ADC do not depend simply on whether or not red blood cell membranes are intact. At the late subacute stage of hematoma, red blood cell lysis occurs and the compartmentalization of methemoglobin is lost, resulting in the elimination of the inhomogeneous susceptibility effect (1, 2, 23). In addition, the intracellular contents are distributed in the extracellular space, possibly causing high viscosity.…”

Section: Discussionmentioning

confidence: 99%

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Diffusion-Weighted MR Imaging of Intracerebral Hemorrhage

et al. 2001

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ObjectiveTo document the signal characteristics of intracerebral hemorrhage (ICH) at evolving stages on diffusion-weighted images (DWI) by comparison with conventional MR images.Materials and MethodsIn our retrospective study, 38 patients with ICH underwent a set of imaging sequences that included DWI, T1-and T2-weighted imaging, and fluid-attenuated inversion recovery (FLAIR). In 33 and 10 patients, respectively, conventional and echo-planar T2* gradient-echo images were also obtained. According to the time interval between symptom onset and initial MRI, five stages were categorized: hyperacute (n=6); acute (n=7); early subacute (n=7); late subacute (n=10); and chronic (n=8). We investigated the signal intensity and apparent diffusion coefficient (ADC) of ICH and compared the signal intensities of hematomas at DWI and on conventional MR images.ResultsDWI showed that hematomas were hyperintense at the hyperacute and late subacute stages, and hypointense at the acute, early subacute and chronic stages. Invariably, focal hypointensity was observed within a hyperacute hematoma. At the hyperacute, acute and early subacute stages, hyperintense rims that corresponded with edema surrounding the hematoma were present. The mean ADC ratio was 0.73 at the hyperacute stage, 0.72 at the acute stage, 0.70 at the early subacute stage, 0.72 at the late subacute stage, and 2.56 at the chronic stage.ConclusionDWI showed that the signal intensity of an ICH may be related to both its ADC value and the magnetic susceptibility effect. In patients with acute stroke, an understanding of the characteristic features of ICH seen at DWI can be helpful in both the characterization of intracranial hemorrhagic lesions and the differentiation of hemorrhage from ischemia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Diffusion-Weighted MR Imaging of Intracerebral Hemorrhage

et al. 2001

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“…This is due to the formation of a meshwork of fibrin fibrils and globin molecules. The globin (protein) component of the hemoglobin has a high density [11]. Moreover, due to incipient clot retraction, the hematocrit may increase to 90 %, thereby further augmenting the density.…”

Section: Computed Tomographymentioning

confidence: 99%

Intracranial hemorrhage: principles of CT and MRI interpretation

et al. 2001

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Accurate diagnosis of intracranial hemorrhage represents a frequent challenge for the practicing radiologist. The purpose of this article is to provide the reader with a synoptic overview of the imaging characteristics of intracranial hemorrhage, using text, tables, and figures to illustrate time-dependent changes. We examine the underlying physical, biological, and biochemical factors of evolving hematoma and correlate them with the aspect on cross-sectional imaging techniques. On CT scanning, the appearance of intracranial blood is determined by density changes which occur over time, reflecting clot formation, clot retraction, clot lysis and, eventually, tissue loss. However, MRI has become the technique of choice for assessing the age of an intracranial hemorrhage. On MRI the signal intensity of intracranial hemorrhage is much more complex and is influenced by multiple variables including: (a) age, location, and size of the lesion; (b) technical factors (e.g., sequence type and parameters, field strength); and (c) biological factors (e.g., pO2, arterial vs. venous origin, tissue pH, protein concentration, presence of a blood-brain barrier, condition of the patient). We discuss the intrinsic magnetic properties of sequential hemoglobin degradation products. The differences in evolution between extra- and intracerebral hemorrhages are addressed and illustrated.

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“…The MRI pattern of an acute hematoma (1-3 days after injury) is usually affected by RBC deoxyhemoglobin. T2 shortening occurs earliest in the center of the hematoma, which is consistent with the more limited oxygen supply to this area (27). In the present study, the T2WI of hematomas one day after injury revealed central hypointensity in 56% of the cases.…”

Section: Discussionmentioning

confidence: 67%

Serial MR Imaging of Intramuscular Hematoma: Experimental Study in a Rat Model with the Pathologic Correlation

et al. 2011

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ObjectiveWe wanted to demonstrate the temporal changes of the magnetic resonance imaging (MRI) findings in experimentally-induced intramuscular hematomas in rats and to correlate these data with the concurrent pathologic observations.Materials and MethodsIntramuscular hematoma was induced in 30 rats. The MR images were obtained at 1, 4, 7 and 10 days and at 2, 3, 4, 6 and 8 weeks after muscle injury. The characteristic serial MRI findings were evaluated and the relative signal intensities were calculated. Pathologic specimens were obtained at each time point.ResultsOn the T1-weighted imaging (T1WI), the intramuscular hematomas exhibited isointensity compared to that of muscle or the development of a high signal intensity (SI) rim on day one after injury. The high SI persisted until eight weeks after injury. On the T2-weighted imaging (T2WI), the hematomas showed high SI or centrally low SI on day one after injury, and mainly high SI after four days. A dark signal rim was apparent after seven days, which was indicative of hemosiderin on the pathology. The gradient echo (GRE) imaging yielded dark signal intensities at all stages.ConclusionUnlike brain hematomas, experimentally-induced intramuscular hematomas show increased SI on both the T1WI and T2WI from the acute stage onward, and this is pathologically correlated with a rich blood supply and rapid healing response to injury in the muscle. On the T2WI and GRE imaging, high SI with a peripheral dark signal rim is apparent from seven days to the chronic stage.

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MR Imaging of Cerebral Hematomas at Different Field Strengths

Cited by 71 publications

References 0 publications

Diffusion-Weighted MR Imaging of Intracerebral Hemorrhage

Diffusion-Weighted MR Imaging of Intracerebral Hemorrhage

Intracranial hemorrhage: principles of CT and MRI interpretation

Serial MR Imaging of Intramuscular Hematoma: Experimental Study in a Rat Model with the Pathologic Correlation

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