Magnetic resonance imaging (MRI) of bruises: a pilot study

The purpose of this study was to investigate if magnetic resonance imaging (MRI) could be used to image the presence of hemosiderin in bruises and if there was the potential for this technique to be applied as a non-invasive method to estimate the age of bruises. To achieve this aim an animal model to produce lesions resembling bruises was created by injecting blood obtained from the tail vein subcutaneously into an area of the abdominal wall. The animals were euthanized at 3, 6, 12 h, 1, 2, 3, 5, and 7 days post injection and the skin of the abdominal wall was excised for MRI scanning and histological examination. The injected blood appeared as hypointense (dark) areas on the T2* MRI at 3 and 6 h. The image of the injected areas became indistinct at 12 h and continued to be indistinct at 1 and 2 days, although there appeared to be transitioning from hypointensity to hyperintensity (light). The magnetic resonance image appeared to better correspond to the histological appearance at 3 and 5 days, with the "bruise" appearing hyperintense (white); however, some hypointense (darker) areas at 3 day possibly corresponded to the development of hemosiderin. At 7 day the injected blood had been converted to hemosiderin with possible correlation between areas of blue staining in Perls' stained histologic sections and areas of extreme hypointensity in the T2* magnetic resonance image. This study has shown that a series of changes occur on MRI of bruises in an animal model that may relate to histological changes. Although variability in the intensity of the MRI signal and considerable soft tissue artifact currently make interpretations difficult, this may be a technique worth pursuing in the non-invasive evaluation of bruises.