Effect of motion on the sonographic and magnetic resonance patterns of ageing blood

The sonographic appearance of a hematoma may be affected by various factors, including the age of the hematoma. The effect of mechanical motion on the echogenicity and histologic appearance, and on the proton relaxation times T1 and T2 of blood clots, was studied in vitro for up to 21 days. All clots were of similar echogenicity and microscopic appearance during the first 2 days. The minimally disturbed clots were sonolucent from day 4 onwards, whereas moderate mechanical disturbance changed the microscopic structure of the blood clots and caused them to retain their echogenicity. Proton relaxation times T1 and T2 of both minimally disturbed and vigorously manipulated blood samples showed a rapid shortening of T1 and a less marked decrease of T2 between days 1 and 4, which was independent of mechanical motion. The ultrasonic appearance reflected the histologic appearance but not necessarily the age of the clot. The magnetic resonance (MR) parameters T1 and to a lesser extent T2 accurately reflected the age of the clot during the first 6 days. Although relatively gentle motion caused a large change in the ultrasonic appearance of the clots, vigorous shaking did not affect the magnetic resonance appearance of human blood clots.