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Long-term visibility of primary intracerebral hemorrhage on magnetic resonance imaging

Marion Dimigen1, Sarah Keir, Martin Dennis

  • 1Department of Clinical Neurosciences, Western General Hospital, Edinburgh, United Kingdom.

Journal of Stroke and Cerebrovascular Diseases : the Official Journal of National Stroke Association
|October 2, 2007
PubMed
Abstract

Insights

Gradient echo recalled (GRE) magnetic resonance imaging (MRI) sequences are essential for detecting old primary intracerebral hemorrhage (PICH), as other sequences may miss some cases. Recurrent PICH and microhemorrhages are common in stroke survivors.

Area of Science:

  • Neurology
  • Radiology
  • Medical Imaging

Background:

  • The long-term detectability of primary intracerebral hemorrhage (PICH) using magnetic resonance imaging (MRI) is not well-established.
  • The necessity of specific MRI sequences, such as gradient echo recalled (GRE), for detecting chronic PICH requires clarification.

Purpose of the Study:

  • To evaluate the long-term detectability of PICH using various MRI sequences.
  • To determine the efficacy of GRE sequences compared to other MRI techniques for identifying old PICH.

Main Methods:

  • A prospective cohort of stroke survivors with a history of PICH underwent MRI at least 3 months post-hemorrhage.
  • Multiple MRI sequences (SE T2, FSE T2/PD, FLAIR, GRE) were compared in a blinded assessment.
  • Detection rates of PICH, infarcts, and microhemorrhages were analyzed for each sequence.

Main Results:

  • Between 61% (FLAIR) and 100% (GRE) of PICHs were identifiable at a median of 3 years post-hemorrhage.
  • Fast spin echo T2 (FSE T2) sequences missed 3.4% of PICHs.
  • New PICH occurred in 29% of patients, and 38% exhibited microhemorrhages.

Conclusions:

  • While FSE T2 sequences detect most old PICHs, GRE sequences are crucial for definitive identification.
  • Recurrent PICH and the presence of microhemorrhages are frequent findings in patients with a history of intracerebral hemorrhage.

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