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A characteristic feature of acute haematomas in the brain on echo-planar diffusion-weighted imaging
1Department of Radiology, School of Medicine, University of Tokushima, 3-18-15, Kuramoto-Cho, Tokushima 770-8503, Japan.
Abstract:
Diffusion-weighted MRI (DWI) is used in the diagnosis of acute ischaemic disease of the brain, but it is not clear whether or not it can be used to differentiate an acute haematoma from an infarct. Our purpose was to identify any characteristic feature of acute haematomas which can be recognised on DWI and to evaluate the usefulness of DWI in acute cerebral stroke. We examined nine patients with acute haemorrhage using CT and MRI including DWI. We measured the volume and apparent diffusion coefficient (ADC) of the haematomas. All showed heterogeneous signal on DWI, and the centre of the large (>20 ml) haematomas especially a mixed pattern with high and low signal. The characteristic feature of acute haematomas was a peripheral low-signal region, found in all subjects regardless of the size of the haematoma; acute infarcts did not show this. This low-signal rim on DWI may be useful for differentiating an acute haematoma from an infarct.
Insights
Diffusion-weighted MRI (DWI) can help differentiate acute brain hematomas from infarcts. A characteristic peripheral low-signal rim on DWI is key to identifying hematomas, aiding acute cerebral stroke diagnosis.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Diffusion-weighted MRI (DWI) is crucial for diagnosing acute ischemic stroke.
- Differentiating acute cerebral hematomas from infarcts using DWI remains challenging.
Purpose of the Study:
- To identify characteristic DWI features of acute hematomas.
- To evaluate the utility of DWI in distinguishing acute cerebral hematomas from infarcts.
Main Methods:
- Nine patients with acute cerebral hemorrhage underwent CT and DWI.
- Hematoma volume and apparent diffusion coefficient (ADC) were measured.
- DWI signal characteristics were analyzed.
Main Results:
- Acute hematomas exhibited heterogeneous DWI signals, with large hematomas (>20 ml) showing mixed high and low central signals.
- A consistent peripheral low-signal rim was observed in all acute hematomas, irrespective of size.
- Acute infarcts did not display this peripheral low-signal rim.
Conclusions:
- The peripheral low-signal rim on DWI is a characteristic feature of acute cerebral hematomas.
- DWI is a valuable tool for differentiating acute hematomas from infarcts in acute cerebral stroke cases.