Intracerebral hemorrhage MRI: Difference between revisions
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MRI is better than CT for detection of acute and chronic [[hemorrhage]]. Therefore it should be the preferred test for [[accurate]] diagnosis of patients with suspected intracerebral hemorrhage.<ref name="pmid17258669">{{cite journal| author=Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM et al.| title=Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. | journal=Lancet | year= 2007 | volume= 369 | issue= 9558 | pages= 293-8 | pmid=17258669 | doi=10.1016/S0140-6736(07)60151-2 | pmc=1859855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17258669 }} </ref> | MRI is better than CT for detection of acute and chronic [[hemorrhage]]. Therefore it should be the preferred test for [[accurate]] diagnosis of patients with suspected intracerebral hemorrhage.<ref name="pmid17258669">{{cite journal| author=Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM et al.| title=Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. | journal=Lancet | year= 2007 | volume= 369 | issue= 9558 | pages= 293-8 | pmid=17258669 | doi=10.1016/S0140-6736(07)60151-2 | pmc=1859855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17258669 }} </ref> | ||
*T2 susceptibility-weighted MRI are as sensitive as CT for detection of acute blood and are more sensitive for identification of prior hemorrhage.<ref name="pmid17258669">{{cite journal| author=Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM et al.| title=Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. | journal=Lancet | year= 2007 | volume= 369 | issue= 9558 | pages= 293-8 | pmid=17258669 | doi=10.1016/S0140-6736(07)60151-2 | pmc=1859855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17258669 }} </ref> | *T2 susceptibility-weighted MRI are as sensitive as CT for detection of acute blood and are more sensitive for identification of prior hemorrhage.<ref name="pmid17258669">{{cite journal| author=Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM et al.| title=Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison. | journal=Lancet | year= 2007 | volume= 369 | issue= 9558 | pages= 293-8 | pmid=17258669 | doi=10.1016/S0140-6736(07)60151-2 | pmc=1859855 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17258669 }} </ref> | ||
*The appearance of Intracerebral hemorrhage on MRI depends on the age of the hematoma and the type of MR sequence (T1-MRI or T2-MRI). | |||
*As the [[hematoma]] ages, [[hemoglobin]] (Hb) goes through the following stages: | |||
*Initial 7 days: oxy-Hb deoxy-Hb, and met-Hb | |||
{| class="wikitable" | |||
!Stage | |||
!Age | |||
!Hemoglobin | |||
!T1-MRI | |||
!T2-MRI | |||
|- | |||
|Hyperacute | |||
|< 24 hours | |||
|Intracellular [[Oxyhemoglobin|oxy-Hb]] | |||
|Isointense | |||
|Very hyperintense | |||
|- | |||
|Acute | |||
|1-3 days | |||
|Intracellular [[Deoxyhemoglobin|deoxy-Hb]] | |||
|Slightly hypointense | |||
|Very hypointense | |||
|- | |||
|Early subacute | |||
|>3 days | |||
|Intracellular [[Methemoglobin|met-Hb]] | |||
|Very hyperintense | |||
|Very hypointense | |||
|- | |||
|Late subacute | |||
|>7 days | |||
|Extracellular [[Methemoglobin|met-Hb]] | |||
|Very hyperintense | |||
|Very hypointense | |||
|- | |||
|Chronic center | |||
|>14 days | |||
|Extracellular hemichromes | |||
|Isointense | |||
|Very hyperintense | |||
|- | |||
|Chronic rim | |||
|>14 days | |||
|Intracellular [[hemosiderin]] | |||
|Slightly hypointense | |||
|Very hypointense | |||
|} | |||
==Images== | ==Images== |
Revision as of 17:08, 30 November 2016
Intracerebral hemorrhage Microchapters |
Diagnosis |
---|
Treatment |
AHA/ASA Guidelines for the Management of Spontaneous Intracerebral Hemorrhage (2015) |
AHA/ASA Guideline Recommendation for the Primary Prevention of Stroke (2014) |
Case Studies |
Intracerebral hemorrhage MRI On the Web |
American Roentgen Ray Society Images of Intracerebral hemorrhage MRI |
Risk calculators and risk factors for Intracerebral hemorrhage MRI |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Mehrsefat, M.D. [2]
Overview
MRI is better than CT for detection of acute and chronic hemorrhage. Therefore it should be the preferred test for accurate diagnosis of patients with suspected intracerebral hemorrhage.[1]
MRI
MRI is better than CT for detection of acute and chronic hemorrhage. Therefore it should be the preferred test for accurate diagnosis of patients with suspected intracerebral hemorrhage.[1]
- T2 susceptibility-weighted MRI are as sensitive as CT for detection of acute blood and are more sensitive for identification of prior hemorrhage.[1]
- The appearance of Intracerebral hemorrhage on MRI depends on the age of the hematoma and the type of MR sequence (T1-MRI or T2-MRI).
- As the hematoma ages, hemoglobin (Hb) goes through the following stages:
- Initial 7 days: oxy-Hb deoxy-Hb, and met-Hb
Stage | Age | Hemoglobin | T1-MRI | T2-MRI |
---|---|---|---|---|
Hyperacute | < 24 hours | Intracellular oxy-Hb | Isointense | Very hyperintense |
Acute | 1-3 days | Intracellular deoxy-Hb | Slightly hypointense | Very hypointense |
Early subacute | >3 days | Intracellular met-Hb | Very hyperintense | Very hypointense |
Late subacute | >7 days | Extracellular met-Hb | Very hyperintense | Very hypointense |
Chronic center | >14 days | Extracellular hemichromes | Isointense | Very hyperintense |
Chronic rim | >14 days | Intracellular hemosiderin | Slightly hypointense | Very hypointense |
Images
The following are images associated with intracerebral hemorrhage involves the left lentiform nucleus and internal capsule.[2]
References
- ↑ 1.0 1.1 1.2 Chalela JA, Kidwell CS, Nentwich LM, Luby M, Butman JA, Demchuk AM; et al. (2007). "Magnetic resonance imaging and computed tomography in emergency assessment of patients with suspected acute stroke: a prospective comparison". Lancet. 369 (9558): 293–8. doi:10.1016/S0140-6736(07)60151-2. PMC 1859855. PMID 17258669.
- ↑ Intracerebral Hemotrrhage https://radiopaedia.org/cases/intracerebral-haemorrhage-2 Accessed on November 9, 2016