Imaging Diagnosis of Chronic Encapsulated Intracerebral Hematoma, a Comparison of Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) characteristics

Summary Background Chronic encapsulated intracerebral hematoma (CEICH) is a rare type of intracerebral hematoma that is often misdiagnosed. To explore the characteristics of CEICH on computerized tomography (CT) and magnetic resonance imaging (MRI). Material/Methods Clinical, CT, MRI, and susceptibility weighted imaging (SWI) data of 5 patients who were diagnosed with CEICH on surgery and pathology were retrospectively analyzed. Results CT showed quasi-circular or elliptical lesions with clear borders in all 5 cases and iso-density or low-density in the center of lesions that were surrounded by peripheral edema in 2 cases. CT showed mass effect in 5 patients. On contrast-enhanced CT, 2 cases exhibited mild ring enhancement, and 3 cases exhibited moderate ring enhancement. MRI showed cystic lesions with high uniform signal on T1-weighted images (T1WI) and T2-weighted images (T2WI), a lowsignal ring sign on the coated cystic lesions on T2WI, a lower signal ring sign on SWI, and ring enhancement after administration of contrast. Conclusions CT imaging of CEICH did not reveal any typical characteristics in the studied patients. MRI showed an envelope with a “ring” and intra-capsular bleeding features. MRI is an effective imaging modality for the diagnosis of CEICH.