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MR imaging of brainstem hemorrhage
1Department of Neurosurgery, Baba Memorial Hospital, Osaka, Japan.
Abstract:
To determine the chronologic changes in the MR appearance of brainstem hemorrhage and to evaluate the clinical efficacy of MR imaging, 15 patients were examined with a 0.5-T MR scanner with inversion-recovery (IR) and T2-weighted spin-echo (SE) images. In the acute stage (up to the sixth day), hematomas were hypo- or isointense on IR images and isointense and then hypointense on SE images. In the subacute stages (the seventh day to 2 months), hematomas changed from hypo- or isointensity to hyperintensity centripetally on IR images and to hyperintensity on SE images. Parenchymal reactions were hypointense first on SE images and then on IR images. In the chronic stage (over 2 months), hematomas "disappeared" and the parenchyma was hypointense on both IR and SE images. The superior clinical efficacy of MR imaging relative to CT for the detection of hemorrhage was obvious except in the acute stage, when hematomas had an intensity similar to that of the adjacent brainstem, and the patients usually were in serious condition.
Insights
Magnetic resonance (MR) imaging effectively tracks brainstem hemorrhage evolution over time. MR imaging demonstrates superior clinical efficacy for detecting hemorrhage compared to CT, except in the acute phase.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Brainstem hemorrhage diagnosis and monitoring are critical for patient outcomes.
- Understanding the temporal evolution of brainstem hemorrhage on MR imaging aids clinical management.
Purpose of the Study:
- To characterize the chronologic changes in the MR appearance of brainstem hemorrhage.
- To evaluate the clinical efficacy of MR imaging in detecting brainstem hemorrhage.
Main Methods:
- A 0.5-T MR scanner was used to examine 15 patients with brainstem hemorrhage.
- Inversion-recovery (IR) and T2-weighted spin-echo (SE) sequences were employed.
Main Results:
- Acute stage (up to 6 days): Hematomas showed variable intensity on IR and SE images.
- Subacute stage (7 days to 2 months): Hematomas became hyperintense on both IR and SE images.
- Chronic stage (>2 months): Hematomas "disappeared" with hypointense parenchyma on both sequences.
Conclusions:
- MR imaging reveals distinct, time-dependent changes in brainstem hemorrhage appearance.
- MR imaging offers superior detection of hemorrhage compared to CT, particularly in subacute and chronic stages.