Comparison of Five MR Sequences for the Detection of Acute Intracranial Hemorrhage

Purpose: To evaluate the respective value of 5 MR sequences to distinguish between stroke patients with and without acute intracerebral hemorrhage (ICH). Methods: MR images obtained ≤6 h after stroke onset of 86 patients (43 ICH, 43 non-ICH) were reviewed by 3 observers who looked for signs of acute ICH on each image set [T1 and T2 gradient echo (GRE), FLAIR, T2-EPI and DWI], presented separately. Results: For the identification of ICH, intraobserver and interobserver concordance were at least ĸ = 0.95 for all sequences. Of all interpretations, 7 (0.4%) were erroneous, with sensitivity and specificity of FLAIR, T2-EPI and DWI reaching 100%; GRE sensitivity and specificity were 100% and 95–97.5%, respectively; T1 sensitivity and specificity were 97.3–100% and 97.4–100%, respectively. All 4 patients misclassified on one pulse sequence were correctly classified on all the other sequences. Conclusion: In the setting of acute stroke, each of the 5 studied sequences enables ICH and non-ICH patients to be distinguished with high sensitivity and specificity.

[1]  C. Oppenheim,et al.  Spontaneous intracerebral hematoma on diffusion-weighted images: influence of T2-shine-through and T2-blackout effects. , 2005, AJNR. American journal of neuroradiology.

[2]  John A Butman,et al.  Comparison of MRI and CT for detection of acute intracerebral hemorrhage. , 2004, JAMA.

[3]  N. Nighoghossian,et al.  Contribution of Susceptibility-Weighted Imaging to Acute Stroke Assessment , 2004, Stroke.

[4]  G. Cosnard,et al.  Comparison of CT and three MR sequences for detecting and categorizing early (48 hours) hemorrhagic transformation in hyperacute ischemic stroke. , 2004, AJNR. American journal of neuroradiology.

[5]  A. Villringer,et al.  Stroke Magnetic Resonance Imaging Is Accurate in Hyperacute Intracerebral Hemorrhage: A Multicenter Study on the Validity of Stroke Imaging , 2004, Stroke.

[6]  Jérôme Honnorat,et al.  Thrombolysis for Ischemic Stroke in Patients with Old Microbleeds on Pretreatment MRI , 2003, Cerebrovascular Diseases.

[7]  T. Rainer,et al.  B0 Images Obtained From Diffusion‐Weighted Echo Planar Sequences for the Detection of Intracerebral Bleeds , 2003, Journal of neuroimaging : official journal of the American Society of Neuroimaging.

[8]  M. Harada,et al.  A characteristic feature of acute haematomas in the brain on echo-planar diffusion-weighted imaging , 2002, Neuroradiology.

[9]  C. Filippi,et al.  Detection of intracranial hemorrhage: comparison between gradient-echo images and b(0) images obtained from diffusion-weighted echo-planar sequences. , 2001, AJNR. American journal of neuroradiology.

[10]  S. Atlas,et al.  Diffusion measurements in intracranial hematomas: implications for MR imaging of acute stroke. , 2000, AJNR. American journal of neuroradiology.

[11]  Jean A. Tkach,et al.  Hemorrhage detected using MR imaging in the setting of acute stroke: an in vivo model. , 1999, AJNR. American journal of neuroradiology.

[12]  S. Warach,et al.  MRI features of intracerebral hemorrhage within 2 hours from symptom onset. , 1999, Stroke.

[13]  M Takahashi,et al.  Detection of intracranial hemorrhage with susceptibility-weighted MR sequences. , 1999, AJNR. American journal of neuroradiology.

[14]  J S Lewin,et al.  Hyperacute stroke: ultrafast MR imaging to triage patients prior to therapy. , 1999, Radiology.

[15]  W Hacke,et al.  A standardized MRI stroke protocol: comparison with CT in hyperacute intracerebral hemorrhage. , 1999, Stroke.

[16]  S W Atlas,et al.  MR detection of hyperacute parenchymal hemorrhage of the brain. , 1998, AJNR. American journal of neuroradiology.

[17]  M. Fukunaga,et al.  Hemorrhagic and nonhemorrhagic stroke: diagnosis with diffusion-weighted and T2-weighted echo-planar MR imaging. , 1997, Radiology.

[18]  R. Edelman,et al.  Detection of hyperacute primary intraparenchymal hemorrhage by magnetic resonance imaging. , 1996, Stroke.

[19]  W. Yuh,et al.  MR imaging of cerebral ischemia: findings in the first 24 hours. , 1991, AJNR. American journal of neuroradiology.

[20]  P. Cahill,et al.  MR imaging of acute intracranial hemorrhage: findings on sequential spin-echo and gradient-echo images in a dog model. , 1991, AJNR. American journal of neuroradiology.

[21]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.