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Assessment of lacunar hemorrhage associated with hypertensive stroke by echo-planar gradient-echo T2*-weighted MRI
T Kinoshita1, T Okudera, H Tamura
1Department of Radiology, Research Institute of Brain and Blood Vessels-Akita, Akita, Japan. kino2grape.med.tottori-u.ac.jp
Background And Purpose:
Echo-planar gradient-echo T2*-weighted MR imaging (GRE-EPI) may detect hypointense lesions representing microhemorrhages with high sensitivity. The aim of this study was to evaluate the effectiveness of GRE-EPI for detecting old lacunar hemorrhages in hypertensive patients with stroke.
Methods:
GRE-EPI was performed with a 1.5-T MRI system in 198 hypertensive patients with stroke (130 patients with hemorrhagic stroke and 68 patients with multiple lacunar stroke) and 66 age-matched healthy elderly individuals.
Results:
Concomitant hypointense foci were found in 84 (66%) patients with hemorrhagic stroke, 46 (68%) patients with multiple lacunar stroke, and 3 (5%) healthy elderly individuals. These hypointense foci were noted in the lentiform nucleus in 61 (47%) patients with hemorrhagic stroke, in the caudate nucleus in 9 (7%) patients, in the thalamus in 54 (42%) patients, in the corticosubcortical region in 57 (44%) patients, in the brain stem in 40 (34%) patients, and in the cerebellum in 32 (25%) patients.
Conclusions:
GRE-EPI is effective for the detection of lacunar hemorrhages induced by hypertension.
Insights
Gradient-echo echo-planar imaging (GRE-EPI) effectively detects microhemorrhages in hypertensive stroke patients. This MRI technique aids in identifying old lacunar hemorrhages, crucial for understanding stroke pathology.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Hypertension is a significant risk factor for stroke.
- Microhemorrhages, often indicative of hypertensive damage, can be challenging to detect.
- Gradient-echo echo-planar imaging (GRE-EPI) shows promise for sensitive microhemorrhage detection.
Purpose of the Study:
- To assess the efficacy of GRE-EPI in identifying old lacunar hemorrhages.
- To evaluate GRE-EPI's sensitivity in hypertensive patients with stroke.
Main Methods:
- 1.5-T MRI using GRE-EPI was performed.
- 198 hypertensive patients with stroke were included (130 hemorrhagic, 68 lacunar).
- 66 age-matched healthy individuals served as controls.
Main Results:
- Hypointense foci (microhemorrhages) were detected in 66% of hemorrhagic stroke patients and 68% of lacunar stroke patients.
- These foci were prevalent in various brain regions, including the thalamus, corticosubcortical areas, and brainstem.
- Only 5% of healthy controls showed such findings, highlighting the technique's specificity.
Conclusions:
- GRE-EPI is a sensitive and effective method for detecting lacunar hemorrhages in hypertensive patients.
- The findings support the use of GRE-EPI in the diagnosis and management of stroke in this population.