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Diffusion-weighted MRI in the diagnosis of intracranial hematomas

Year 2013, Volume: 18 Issue: 4, 185 - 194, 14.03.2014

Abstract

Abstract. To determinate the diagnostic value of diffusion-weighted MR imaging (DWI) in intracerebral hematomas, epidural hematomas, subdural hematomas, and subarachnoid hemorrhage, and to assess the contribution of diffusion signal characteristics in the differentiation of hematoma stages. In this prospective study, consecutive 67 patients (range: 3-89 years), 35 (18 men 17 women) with intracerebral hematoma, 18 (10 men 8 women) with subdural hematoma, 2 (1 man 1 woman) with epidural hematoma, and 12 (5 men 7 women) with subarachnoid hemorrhage on conventional MRI sequences constituted the case group and were evaluated with DWI. Intracerebral, subdural and epidural hematomas detected on conventional MR sequences were also shown on DWI. But none of the cases with subarachnoid hemorrhage was demonstrated on DWI. All intracranial hematomas detected on DWI except from chronic stage subdural hematomas showed similar signal intensity characteristics on DWI and T2WI, but were hypointense on ADC maps. All intracerebral, subdural and epidural hematomas seen on conventional MR sequences could be detected by DWI. On the contrary, DWI was not an effective imaging method for detecting subarachnoid hemorrhages. Using DWI alone for detecting the stages of hemorrhages can provide only additional information in subdural and intracerebral hematomas, and it is unable to give definite results, and the lesions should be evaluated by the correlation with other conventional MRI sequences. Key words: Diffusion weighted magnetic resonance imaging, intracranial hematomas

References

  • Tsuruda JS, Chew WM, Moseley ME, Norman D. Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. AJNR Am J Neuroradiol 1990; 11: 925-931.
  • Kang BK, Na DG, Ryoo JW, et al. Diffusion-weighted MR imaging of intracerebral hemorrhage. Korean J Radiol 2001; 2: 183-191.
  • Does MD, Zhong J, Gore JC. In vivo measurement of ADC change due to intravascular susceptibility variation. Magn Reson Med 1999; 41: 236-240.
  • González RG, Schaefer PW, Buonanno FS, et al. Diffusion-weighted MR imaging: diagnostic accuracy in patients imaged within 6 hours of stroke symptom onset. Radiology 1999; 210: 155-162.
  • Lin DD, Filippi CG, Steever AB, Zimmerman RD. Detection of intracranial hemorrhage: comparison between gradient-echo images and b(0) images obtained from diffusion-weighted echo-planar sequences. AJNR Am J Neuroradiol 2001; 22: 127512
  • Shimoda M, Hoshikawa K, Shiramizu H, et al. Clinical implications of subarachnoid clots detected by diffusion-weighted imaging in the acute stage of aneurysm rupture. Neurol Med Chir (Tokyo) 2010; 50: 192-1
  • Le Bihan D, Turner R, Douek P, Patronas N. Diffusion MR imaging: clinical applications. AJR Am J Roentgenol 1992; 159: 591-599.
  • Sunshine JL, Tarr RW, Lanzieri CF, et al. Hyperacute stroke: ultrafast MR imaging to triage patients prior to therapy. Radiology 1999; 212: 325-332.
  • Dorenbeck U, Schlaier J, Bretschneider T, Schuierer G, Feuerbach S. Diffusion-weighted imaging with calculated apparent diffusion coefficient in intracranial hemorrhagic lesions. Clin Imaging 2005; 29: 86-93.
  • Atlas SW, DuBois P, Singer MB, Lu D. Diffusion measurements in intracranial hematomas: implications for MR imaging of acute stroke. AJNR Am J Neuroradiol 2000; 21: 1190-1194.
  • Linfante I, Llinas RH, Caplan LR, Warach S. MRI features of intracerebral hemorrhage within 2 hours from symptom onset. Stroke 1999; 30: 2263-2267.
  • Clark RA, Watanabe AT, Bradley WG Jr, Roberts JD. Acute hematomas: effects of deoxygenation, hematocrit, and fibrin-clot formation and retraction on T2 shortening. Radiology 1990; 175: 201-206.
  • Hayman LA, Taber KH, Ford JJ, et al. Effect of clot formation and retraction on spin-echo MR images of blood: an in vitro study. AJNR Am J Neuroradiol 1989; 10: 1155-1158.
  • Hayman LA, Ford JJ, Taber KH, et al. T2 effect of hemoglobin concentration: assessment with in vitro MR spectroscopy. Radiology 1988; 168: 489-491.
  • Hargens AR, Bowie LJ, Lent D, et al. Sickle-cell hemoglobin: fall in osmotic pressure upon deoxygenation. Proc Natl Acad Sci USA 1980; 77: 4310-4312.
  • Schellinger PD, Jansen O, Fiebach JB, Hacke W, Sartor K. A standardized MRI stroke protocol: comparison with CT in hyperacute intracerebral hemorrhage. Stroke 1999; 30: 765-768.
  • Felber S, Auer A, Wolf C, et al. [MRI characteristics of spontaneous intracerebral hemorrhage].[Article in German] Radiologe 1999; 39: 838-846.
  • Wiesmann M, Mayer TE, Yousry I, Hamann GF, Brückmann H. Detection of hyperacute parenchymal hemorrhage of the brain using echo-planar T2*weighted and diffusion-weighted MRI. Eur Radiol 2001; 11: 849-853.
  • Ebisu T, Tanaka C, Umeda M, et al. Hemorrhagic and nonhemorrhagic stroke: diagnosis with diffusionweighted and T2-weighted echo-planar MR imaging. Radiology 1997; 203: 823-828.
  • Gomori JM, Grossman RI, Goldberg HI, Zimmerman RA, Bilaniuk LT. Intracranial hematomas: imaging by high-field MR. Radiology 1985; 157: 87-93.
  • Bradley WG Jr. MR appearance of hemorrhage in the brain. Radiology 1993; 189: 15-26.
  • Brooks RA, Di Chiro G, Patronas N. MR imaging of cerebral hematomas at different field strengths: theory and applications. J Comput Assist Tomogr 1989; 13: 194-20
  • Ekholm S. Intracranial hemorrhages. Rivista di Neuroradiologia 1996; 9: 17–21.
  • Moritani T, Ekholm S, Westesson P. Editors, DW imaging of Brain, Springer Berlin Heidelberg NewYork Business. 2005; 80-81.
  • Kuwahara S, Fukuoka M, Koan Y, et al. Subdural hyperintense band on diffusion-weighted imaging of chronic subdural hematoma indicates bleeding from the outer membrane. Neurol Med Chir (Tokyo) 2005; 45: 125-131.
  • Noguchi K, Ogawa T, Seto H, et al. Subacute and chronic subarachnoid hemorrhage: diagnosis with fluid-attenuated inversion-recovery MR imaging. Radiology 1997; 203: 257-262.
  • Wiesmann M, Mayer TE, Yousry I, et al. Detection of hyperacute subarachnoid hemorrhage of the brain by using magnetic resonance imaging. J Neurosurg 2002; 96: 684-689.
Year 2013, Volume: 18 Issue: 4, 185 - 194, 14.03.2014

Abstract

References

  • Tsuruda JS, Chew WM, Moseley ME, Norman D. Diffusion-weighted MR imaging of the brain: value of differentiating between extraaxial cysts and epidermoid tumors. AJNR Am J Neuroradiol 1990; 11: 925-931.
  • Kang BK, Na DG, Ryoo JW, et al. Diffusion-weighted MR imaging of intracerebral hemorrhage. Korean J Radiol 2001; 2: 183-191.
  • Does MD, Zhong J, Gore JC. In vivo measurement of ADC change due to intravascular susceptibility variation. Magn Reson Med 1999; 41: 236-240.
  • González RG, Schaefer PW, Buonanno FS, et al. Diffusion-weighted MR imaging: diagnostic accuracy in patients imaged within 6 hours of stroke symptom onset. Radiology 1999; 210: 155-162.
  • Lin DD, Filippi CG, Steever AB, Zimmerman RD. Detection of intracranial hemorrhage: comparison between gradient-echo images and b(0) images obtained from diffusion-weighted echo-planar sequences. AJNR Am J Neuroradiol 2001; 22: 127512
  • Shimoda M, Hoshikawa K, Shiramizu H, et al. Clinical implications of subarachnoid clots detected by diffusion-weighted imaging in the acute stage of aneurysm rupture. Neurol Med Chir (Tokyo) 2010; 50: 192-1
  • Le Bihan D, Turner R, Douek P, Patronas N. Diffusion MR imaging: clinical applications. AJR Am J Roentgenol 1992; 159: 591-599.
  • Sunshine JL, Tarr RW, Lanzieri CF, et al. Hyperacute stroke: ultrafast MR imaging to triage patients prior to therapy. Radiology 1999; 212: 325-332.
  • Dorenbeck U, Schlaier J, Bretschneider T, Schuierer G, Feuerbach S. Diffusion-weighted imaging with calculated apparent diffusion coefficient in intracranial hemorrhagic lesions. Clin Imaging 2005; 29: 86-93.
  • Atlas SW, DuBois P, Singer MB, Lu D. Diffusion measurements in intracranial hematomas: implications for MR imaging of acute stroke. AJNR Am J Neuroradiol 2000; 21: 1190-1194.
  • Linfante I, Llinas RH, Caplan LR, Warach S. MRI features of intracerebral hemorrhage within 2 hours from symptom onset. Stroke 1999; 30: 2263-2267.
  • Clark RA, Watanabe AT, Bradley WG Jr, Roberts JD. Acute hematomas: effects of deoxygenation, hematocrit, and fibrin-clot formation and retraction on T2 shortening. Radiology 1990; 175: 201-206.
  • Hayman LA, Taber KH, Ford JJ, et al. Effect of clot formation and retraction on spin-echo MR images of blood: an in vitro study. AJNR Am J Neuroradiol 1989; 10: 1155-1158.
  • Hayman LA, Ford JJ, Taber KH, et al. T2 effect of hemoglobin concentration: assessment with in vitro MR spectroscopy. Radiology 1988; 168: 489-491.
  • Hargens AR, Bowie LJ, Lent D, et al. Sickle-cell hemoglobin: fall in osmotic pressure upon deoxygenation. Proc Natl Acad Sci USA 1980; 77: 4310-4312.
  • Schellinger PD, Jansen O, Fiebach JB, Hacke W, Sartor K. A standardized MRI stroke protocol: comparison with CT in hyperacute intracerebral hemorrhage. Stroke 1999; 30: 765-768.
  • Felber S, Auer A, Wolf C, et al. [MRI characteristics of spontaneous intracerebral hemorrhage].[Article in German] Radiologe 1999; 39: 838-846.
  • Wiesmann M, Mayer TE, Yousry I, Hamann GF, Brückmann H. Detection of hyperacute parenchymal hemorrhage of the brain using echo-planar T2*weighted and diffusion-weighted MRI. Eur Radiol 2001; 11: 849-853.
  • Ebisu T, Tanaka C, Umeda M, et al. Hemorrhagic and nonhemorrhagic stroke: diagnosis with diffusionweighted and T2-weighted echo-planar MR imaging. Radiology 1997; 203: 823-828.
  • Gomori JM, Grossman RI, Goldberg HI, Zimmerman RA, Bilaniuk LT. Intracranial hematomas: imaging by high-field MR. Radiology 1985; 157: 87-93.
  • Bradley WG Jr. MR appearance of hemorrhage in the brain. Radiology 1993; 189: 15-26.
  • Brooks RA, Di Chiro G, Patronas N. MR imaging of cerebral hematomas at different field strengths: theory and applications. J Comput Assist Tomogr 1989; 13: 194-20
  • Ekholm S. Intracranial hemorrhages. Rivista di Neuroradiologia 1996; 9: 17–21.
  • Moritani T, Ekholm S, Westesson P. Editors, DW imaging of Brain, Springer Berlin Heidelberg NewYork Business. 2005; 80-81.
  • Kuwahara S, Fukuoka M, Koan Y, et al. Subdural hyperintense band on diffusion-weighted imaging of chronic subdural hematoma indicates bleeding from the outer membrane. Neurol Med Chir (Tokyo) 2005; 45: 125-131.
  • Noguchi K, Ogawa T, Seto H, et al. Subacute and chronic subarachnoid hemorrhage: diagnosis with fluid-attenuated inversion-recovery MR imaging. Radiology 1997; 203: 257-262.
  • Wiesmann M, Mayer TE, Yousry I, et al. Detection of hyperacute subarachnoid hemorrhage of the brain by using magnetic resonance imaging. J Neurosurg 2002; 96: 684-689.
There are 27 citations in total.

Details

Primary Language English
Journal Section Articles
Authors

Davut Şanlı This is me

Özkan Ünal

Aydın Bora This is me

Mehmet Beyazal

Alpaslan Yavuz

Serhat Avcu This is me

Publication Date March 14, 2014
Published in Issue Year 2013 Volume: 18 Issue: 4

Cite

APA Şanlı, D., Ünal, Ö., Bora, A., Beyazal, M., et al. (2014). Diffusion-weighted MRI in the diagnosis of intracranial hematomas. EASTERN JOURNAL OF MEDICINE, 18(4), 185-194.
AMA Şanlı D, Ünal Ö, Bora A, Beyazal M, Yavuz A, Avcu S. Diffusion-weighted MRI in the diagnosis of intracranial hematomas. EASTERN JOURNAL OF MEDICINE. March 2014;18(4):185-194.
Chicago Şanlı, Davut, Özkan Ünal, Aydın Bora, Mehmet Beyazal, Alpaslan Yavuz, and Serhat Avcu. “Diffusion-Weighted MRI in the Diagnosis of Intracranial Hematomas”. EASTERN JOURNAL OF MEDICINE 18, no. 4 (March 2014): 185-94.
EndNote Şanlı D, Ünal Ö, Bora A, Beyazal M, Yavuz A, Avcu S (March 1, 2014) Diffusion-weighted MRI in the diagnosis of intracranial hematomas. EASTERN JOURNAL OF MEDICINE 18 4 185–194.
IEEE D. Şanlı, Ö. Ünal, A. Bora, M. Beyazal, A. Yavuz, and S. Avcu, “Diffusion-weighted MRI in the diagnosis of intracranial hematomas”, EASTERN JOURNAL OF MEDICINE, vol. 18, no. 4, pp. 185–194, 2014.
ISNAD Şanlı, Davut et al. “Diffusion-Weighted MRI in the Diagnosis of Intracranial Hematomas”. EASTERN JOURNAL OF MEDICINE 18/4 (March 2014), 185-194.
JAMA Şanlı D, Ünal Ö, Bora A, Beyazal M, Yavuz A, Avcu S. Diffusion-weighted MRI in the diagnosis of intracranial hematomas. EASTERN JOURNAL OF MEDICINE. 2014;18:185–194.
MLA Şanlı, Davut et al. “Diffusion-Weighted MRI in the Diagnosis of Intracranial Hematomas”. EASTERN JOURNAL OF MEDICINE, vol. 18, no. 4, 2014, pp. 185-94.
Vancouver Şanlı D, Ünal Ö, Bora A, Beyazal M, Yavuz A, Avcu S. Diffusion-weighted MRI in the diagnosis of intracranial hematomas. EASTERN JOURNAL OF MEDICINE. 2014;18(4):185-94.