• J Chin Med Assoc · Mar 2005

    Comparative Study

    Detection of subarachnoid hemorrhage at acute and subacute/chronic stages: comparison of four magnetic resonance imaging pulse sequences and computed tomography.

    • Mei-Kang Yuan, Ping-Hong Lai, Jeong-Yu Chen, Shu-Shong Hsu, Huei-Lung Liang, Lee-Ren Yeh, Clement Kuen-Huang Chen, Ming-Ting Wu, Huay-Ben Pan, and Chien-Fang Yang.
    • Department of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan, R.O.C.
    • J Chin Med Assoc. 2005 Mar 1;68(3):131-7.

    BackgroundAcute subarachnoid hemorrhage (SAH) has traditionally been diagnosed by computed tomography (CT); however, fluid-attenuated inversion recovery (FLAIR) is a magnetic resonance imaging (MRI) modality currently used to detect acute SAH. CT is insensitive in the detection of subacute or chronic SAH. The purpose of this study was to compare 4 MRI pulse sequences and CT in the detection of SAH in acute and subacute-to-chronic stages.MethodsFrom 2001-2003, we collected data for 22 patients (12 men and 10 women, aged 35-80 years) with SAH due to ruptured aneurysm (n = 11), trauma (3), or unknown origin (8). All patients underwent MRI and CT examination, with an interval of less than 12 hours between the 2 procedures. We divided patients into 2 groups according to the time from symptom onset to MRI evaluation: patients with MRI performed < or = 5 days post-ictus had acute-stage illness, whereas patients with MRI performed from day 6-30 post-ictus had a subacute-to-chronic condition. MRI (1.5-T) pulse sequences comprised spin-echo T1-weighted, fast spin-echo T2-weighted, FLAIR, and gradient-echo (GE) T2*-weighted images.ResultsIn the acute-stage group, SAH was seen as an area of high signal intensity compared with surrounding cerebrospinal fluid in 36.4% of cases on T1-weighted images, and in 100% on FLAIR images; low signal intensities were seen in 18.2% of cases on T2-weighted images, and in 90.9% on GE T2*-weighted images. High-attenuated SAH was seen on CT in 90.9% of cases. FLAIR (p = 0.008), GE T2*-weighted images (p = 0.012) and CT images (p = 0.012) were all statistically significant indicators of acute SAH. In the subacute/chronic-stage group, SAH was detected on T1-weighted images (36.4% of cases), FLAIR (33.3%), T2-weighted images (9.1%), GE T2*-weighted images (100%), and CT (45.5%). GE T2*-weighted images were significantly superior (p = 0.001) to other MRI pulse sequences and CT as indicators of subacute-to-chronic SAH.ConclusionFLAIR and GE T2* MRI pulse sequences, and CT scans, are all statistically significant indicators of acute SAH. GE T2*-weighted images are statistically significant indicators of subacute-to-chronic SAH, whereas other MRI pulse sequences, and CT scans, are not.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…