MRI Features of Intracerebral Hemorrhage Within 2 Hours From Symptom Onset

Linfante, Italo; Llinás, Rafael H.; Caplan, Louis R.; Warach, Steven

doi:10.1161/01.str.30.11.2263

Cited by 262 publications

(150 citation statements)

References 9 publications

Supporting

Mentioning

140

Contrasting

Unclassified

Order By: Relevance

“…The results of several small studies support the hypothesis that deoxyhemoglobin is present within the early hours after SICH and may be detected best by using susceptibility-weighted sequences. 75,98,112 Multimodal MR imaging techniques such as diffusion-and perfusion-weighted sequences may add to its diagnostic reliability in hyperacute SICH.…”

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Spontaneous intracerebral hemorrhage: a review

Fewel¹,

Thompson²,

Hoff³

2003

FOC

148

View full text Add to dashboard Cite

Spontaneous intracerebral hemorrhage (SICH) is a blood clot that arises in the brain parenchyma in the absence of trauma or surgery. This entity accounts for 10 to 15% of all strokes and is associated with a higher mortality rate than either ischemic stroke or subarachnoid hemorrhage. Common causes include hypertension, amyloid angiopathy, coagulopathy, vascular anomalies, tumors, and various drugs. Hypertension, however, remains the single greatest modifiable risk factor for SICH. Computerized tomography scanning is the initial diagnostic modality of choice in SICH, and angiography should be considered in all cases except those involving older patients with preexisting hypertension in thalamic, putaminal, or cerebellar hemorrhage. Medical management includes venous thrombosis prophylaxis, gastric cytoprotection, and aggressive rehabilitation. Anticonvulsant agents should be prescribed in supratentorial SICH, whereas the management of hypertension is controversial. To date, nine prospective randomized controlled studies have been conducted to compare surgical and medical management of SICH. Although definitive evidence favoring surgical intervention is lacking, there is good theoretical rationale for early surgical intervention. Surgery should be considered in patients with moderate to large lobar or basal ganglia hemorrhages and those suffering progressive neurological deterioration. Elderly patients in whom the Glasgow Coma Scale score is less than 5, those with brainstem hemorrhages, and those with small hemorrhages do not typically benefit from surgery. Patients with cerebellar hemorrhages larger than 3 cm, those with brainstem compression and hydrocephalus, or those exhibiting neurological deterioration should undergo surgical evacuation of the clot. It is hoped that the forthcoming results of the International Surgical Trial in IntraCerebral Hemorrhage will help formulate evidence-based recommendations regarding the role of surgery in SICH.

show abstract

Section: Magnetic Resonance Imagingmentioning

confidence: 99%

Spontaneous intracerebral hemorrhage: a review

Fewel¹,

Thompson²,

Hoff³

2003

FOC

148

View full text Add to dashboard Cite

show abstract

“…THE TERM "SUSCEPTIBILITY-WEIGHTED IMAGING" (SWI) in MRI has been used by a few authors to indicate different sequences (1,2) that all have the property of being sensitive to susceptibility effects. Our SWI technique is a novel imaging method that maximizes the sensitivity to susceptibility effects by combining a long-TE, high-resolution, fully flow-compensated, 3D gradient-echo sequence with filtered phase information in each voxel to both enhance the contrast in magnitude images and add a new source of information: the susceptibility difference between tissues (3).…”

mentioning

confidence: 99%

Susceptibility‐weighted imaging to visualize blood products and improve tumor contrast in the study of brain masses

Sehgal

DelProposto

Haddar

et al. 2006

Magnetic Resonance Imaging

188

148

View full text Add to dashboard Cite

Purpose:To evaluate the diagnostic value of susceptibilityweighted imaging (SWI) for studying brain masses. Materials and Methods:SWI is a high-resolution, threedimensional, fully velocity-compensated gradient-echo sequence that uses both magnitude and phase data. Custom postprocessing is applied to enhance the contrast in the magnitude images between tissues with different susceptibilities. This sequence was applied to 44 patients (24 males and 20 females, 15-89 years old, mean age ϭ 50.3 years) with brain masses, pre-and/or postcontrast, and compared with conventional sequences (T1, T1 postcontrast, T2, proton density (PD), fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) at 1.5T). Correlation with pathology was obtained in 12 cases. All images were reviewed independently by three radiologists. Results:In the evaluation of tumor visibility, boundary definition, blood products, venous vasculature, architecture, and edema, SWI gave better information than the standard T1-weighted postcontrast images in 11%, 14%, 71%, 73%, 63%, and 75% of the data, respectively, in a subgroup of 38 patients. This demonstrates that the information presented by SWI is complementary in nature to that available from conventional methods. On the whole, SWI was much more sensitive for showing blood products and venous vasculature. SWI showed a useful FLAIR-like contrast and complemented the information obtained by conventional T1 postcontrast sequences regarding the internal architecture of the lesions. Good pathologic correlations were found for blood products as predicted by SWI.Conclusion: SWI should prove useful for tumor characterization because of its ability to better highlight blood products and venous vasculature and reveal new internal architecture.

show abstract

“…Within the area of microvascular obstruction, there are potentially several tissue types: edematous myocardium (leading to elevated T 2 ), acutely infarcted myocardium (leading to elevated T 1 ) (13), and possibly myocar- dial hemorrhage and its byproducts (which has been shown to lead to decreased T 2 * in the brain [14] and also to interfere with T 2 *-sensitive techniques in the heart) (15). STIR will mostly be highly sensitive to changes in T 2 , with some limited sensitivity to changes in T 1 and very limited sensitivity to changes in T 2 *.…”

Section: Discussionmentioning

confidence: 99%

Single‐shot steady‐state free precession can detect myocardial edema in patients: A feasibility study

Green

Clarke

Flewitt

et al. 2009

Magnetic Resonance Imaging

View full text Add to dashboard Cite

Purpose:To demonstrate the ability of single-shot, T 2 /T 1 weighted steady-state free precession (SSFP) to detect myocardial edema in patients with an acute myocardial infarction. Materials and Methods:This study was performed in a series of patients (n ϭ 10) referred for the assessment of acute myocardial infarcts (AMI). Localizers were used to obtain true short axis views of the left ventricle (LV). These views were used to plan and obtain T 2 -weighted STIR (short TI inversion recovery) images of the LV. These slices were then acquired using single-shot dark blood-prepared SSFP with a large (31) number of dummy pulses. Lastly, Contrast agent was injected, and late enhancement (LE) images were acquired. Images were analyzed using a multi-segment model of the heart. SSFP images were compared with STIR images, with STIR images used as the standard of truth for the presence of edema. LE images were used to identify segments which were positive for microvascular obstruction.Results: All techniques were successful in all patients. A total of 312 segments were analyzed. Excluding segments positive for microvascular obstruction, SSFP had a sensitivity/specificity of 80%/89%. Including segments positive for microvascular obstruction, sensitivity/specificity was 71%/88%. On a patient-based analysis, no AMI was missed using SSFP (sensitivity ϭ 100%). Conclusion:Using single-shot SSFP to detect myocardial edema in patients with AMI is feasible with a moderate sensitivity and high specificity.

show abstract

MRI Features of Intracerebral Hemorrhage Within 2 Hours From Symptom Onset

Cited by 262 publications

References 9 publications

Spontaneous intracerebral hemorrhage: a review

Spontaneous intracerebral hemorrhage: a review

Susceptibility‐weighted imaging to visualize blood products and improve tumor contrast in the study of brain masses

Single‐shot steady‐state free precession can detect myocardial edema in patients: A feasibility study

Contact Info

Product

Resources

About