Intracranial hematomas: imaging by high-field MR.

Gomori, John M.; Grossman, Robert I.; Goldberg, Henry I.; Zimmerman, R A; Bilaniuk, L T

doi:10.1148/radiology.157.1.4034983

Cited by 667 publications

(202 citation statements)

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“…In general, late subacute intracerebral hematoma appears as high intensity on both T 1 -and T 2 -weighted imaging, reflecting lysis of the erythrocytes and predominantly extracellular methemoglobin. [2][3][4] The mean ADC value of the extracellular methemoglobin is 0.58 ± 0.10 × 10 -3 mm 2 /sec. 4) The high intensity areas in the subacute hematoma on diffusion-weighted imaging were considered to mainly consist of extracellular methemoglobin.…”

Section: Discussionmentioning

confidence: 99%

Diffusion-Weighted Imaging of Traumatic Subdural Hematoma in the Subacute Stage-Five Case Reports-

Kuwahara¹,

Fukuoka²,

Koan³

et al. 2005

Neurol. Med. Chir.(Tokyo)

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Five cases of traumatic subdural hematomas in the subacute stage (from 7 to 20 days after head injury) were treated in one male and four females, aged from 63 to 82 years, with evacuation via craniotomy in three and aspiration via burr hole surgery in two. All hematomas were evaluated by T 1 -, T 2 -, and diffusion-weighted magnetic resonance imaging, and measurement of the apparent diffusion coefficient (ADC). Diffusion-weighted imaging showed the hematoma as a crescent high intensity area with a low intensity rim close to the brain surface (two-layered structure) in four cases and as high intensity with low intensity components in one case. The high intensity areas under the dura mater on diffusion-weighted imaging appeared as homogeneous high intensity on T 1 -and T 2 -weighted imaging in four cases, and inhomogeneous high intensity on T 1 -and isointensity on T 2 -weighted imaging in one case. The mean ADC value of the high intensity areas was 0.58 ± 0.23 (mean ± standard deviation) × 10 -3 mm 2 /sec. The operative findings revealed the high intensity areas as solid clots. The low intensity areas on diffusion-weighted imaging appeared as homogeneous high intensity in four cases and inhomogeneous isointensity with high intensity components in one case on T 1 -and T 2 -weighted imaging. The mean ADC value of the low intensity areas was 2.03 ± 0.27 × 10 -3 mm 2 /sec. The operative findings revealed the low intensity areas as mixtures of resolved clot and cerebrospinal fluid. Diffusion-weighted imaging showed the characteristic two-layered structure in traumatic subdural hematomas in the subacute stage, and analysis of the ADC values was useful for differentiating solid from liquid hematoma and for selection of the surgical procedure.

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Section: Discussionmentioning

confidence: 99%

Diffusion-Weighted Imaging of Traumatic Subdural Hematoma in the Subacute Stage-Five Case Reports-

Kuwahara¹,

Fukuoka²,

Koan³

et al. 2005

Neurol. Med. Chir.(Tokyo)

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“…A low intensity area on T2-weighted images in the acute stage is thought to indicate more extensive intramedullary hemorrhage and is attributed to deoxyhemoglobin (Figure 4a). 6,7,12,13 Its presence has been reported to suggest a poor prognosis for neurological recovery. 4,14,15 In our patients, nine of the ten patients exhibiting this low signal change had grade A paralysis from onset to 1 year after injury ( Figure 5: pattern 4).…”

Section: Discussionmentioning

confidence: 99%

Sequential MR studies of cervical cord injury: correlation with neurological damage and clinical outcome

Shimada

Tokioka

1999

Spinal Cord

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In patients with acute traumatic cervical spinal cord injury, it is di cult to make a precise diagnosis of the main site of the injury, the severity of cord damage, and the prognosis of neurological complications Objective: To determine which images provide the most useful information and the best time to perform prognostic MRI. Design: The severity of neurological complications was assessed using the ASIA impairment scale. MRI was ®rst performed within 48 h of injury, and was subsequently performed after 2 ± 3 weeks, 3 months, 6 months, and 1 year. Setting: Inpatient SCI medicine unit. Subjects: Seventy-®ve patients with acute traumatic cervical spinal cord injury (9 women and 66 men) aged from 19 ± 89 years (mean: 54.7 years). Results: Four characteristic patterns of signal changes were observed on MRI. These patterns correlated well with the severity of spinal cord damage and the clinical outcome. Conclusion: T2-weighted images provided the most useful information, and the best times for prognostic imaging were at the time of injury and 2 ± 3 weeks later.

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“…Even in artificial cerebral spinal fluid, hemoglobin changes to methemoglobin after incubation for 84 h at 38 ° C, just like the chemical change observed for NaNO 2 . When hemoglobin changes to methemoglobin, Fe 2+ changes to Fe 3+ , leading to hyperintensity on T1WI [82,83].…”

Section: Ironmentioning

confidence: 99%