Low diagnostic yield in follow-up MR imaging in patients with spontaneous intracerebral hemorrhage with a negative initial MRI

Mouchtouris, Nikolaos; Saiegh, Fadi Al; Chalouhi, Nohra; Sweid, Ahmad; Papai, Emily; Wong, Daniella; Kim, Julie; Saline, Austin; Nauheim, David; Gooch, Reid; Tjoumakaris, Stavropoula; Rosenwasser, Robert H.; Jabbour, Pascal

doi:10.1007/s00234-020-02570-1

Cited by 10 publications

(8 citation statements)

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“…We found that the rate of lesion detection on follow-up MRI for patients with an initial nondiagnostic MRI (3.1%) was lower than the rate of lesion detection on initial admission MRI (5.2%). These findings are similar to those of Mouchtouris et al who found that of 113 patients with a non-diagnostic admission MRI no patients (0%) had a secondary lesion identified on follow-up MRI (6). Similar to the diagnostic utility of an admission MRI in patients with spontaneous ICH, current data do not provide decisive support either for or against a universal policy of follow-up MRI for these patients.…”

Section: Discussionsupporting

confidence: 88%

“…The majority of these studies were limited by small sample sizes with the exception of one study of 400 patients which demonstrated that MRI/MRA of the brain detected a secondary lesion in 12.5% of cases of spontaneous ICH and led to changes in diagnosis and management in 14% and 20% of cases, respectively (4). Data regarding the utility of follow-up brain MRI is even more limited with only one study to date having assessed this question (6). A meta-analysis examining the diagnostic utility of brain MRI in patients with spontaneous ICH has yet to be performed and is warranted.…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Utility of Brain MRI in Spontaneous Intracerebral Hemorrhage: A Retrospective Cohort Study and Meta-Analysis

Wilson

Wang

Андреев

et al. 2023

Preprint

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Background: <break><break>The diagnostic yield of brain Magnetic Resonance Imaging (MRI) in spontaneous intracerebral hemorrhage (ICH) is unclear. We performed both an independent single-center retrospective cohort study and a meta-analysis to assess the detection rate of secondary lesions on MRI in patients with spontaneous ICH.<break> <break><break>Methods:<break><break>In the retrospective cohort study, we examined 856 consecutive patients with spontaneous ICH. Brain MRI scans on admission and follow-up were assessed for secondary lesions. We also examined clinical and CT radiographic variables associated with secondary lesions in univariable analysis. In the meta-analysis we searched PubMed and EMBASE for articles investigating the secondary lesion detection rate on brain MRI in spontaneous ICH. Random-effects models were used to calculate the pooled estimate of secondary lesion detection rate. The meta-analysis used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.<break> <break><break>Results:<break><break>Of the 856 patients with ICH, 481 (56%) had at least one brain BRI performed [7014 years, 270(56% male)]. 462(54%) had an admission MRI and 138(16%) had both admission and follow-up MRIs. The detection rate of secondary lesions on admission MRIs was 24/462(5.2%). 4/127(3.1%) patients with a negative admission MRI had a lesion identified on follow-up MRI. No clinical or radiographic variables were associated with a secondary lesion on MRI using univariable analysis. The meta-analysis included 5 studies total (4 identified in the PubMed and EMBASE searches as well as our own cohort study) comprising 1147 patients with spontaneous ICH who underwent brain MRI. The pooled detection rate of secondary lesions was 11% (95%CI: 7-16%).<break> <break><break>Conclusions:<break><break>No predictors of secondary lesion detection were identified in our cohort study. Prospective studies are required to better understand the diagnostic utility of MRI in spontaneous ICH.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Diagnostic Utility of Brain MRI in Spontaneous Intracerebral Hemorrhage: A Retrospective Cohort Study and Meta-Analysis

Wilson

Wang

Андреев

et al. 2023

Preprint

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“…It has been shown that the expression of MMP-9 in the brain tissue of patients with cerebral hemorrhage is up-regulated; hydrolyzed laminin, collagen fibers, and other causes of cell tight junctions and extracellular matrix molecules are destroyed, the permeability of cerebral vascular barrier is increased, and the occurrence of cerebral edema is promoted (10,11). Mouchtouris et al (12) found that the MMP-9 levels of hypertensive cerebral hemorrhage patients with neurological symptoms within 24 hours were significantly increased, and were positively correlated to the degree of edema around the hematoma as well as to patients with consciousness disturbance. In this study, it was observed that the 5 and 15 d REI and AEI values in the low MMP-9 group were significantly lower than those in the high MMP-9 group after admission, and were positively correlated with the edema indexes REI and AEI.…”

Section: Discussionmentioning

confidence: 99%

Correlation analysis between TSP2, MMP-9 and perihematoma edema, as well as the short-term prognosis of patients with hypertensive intracerebral hemorrhage

Cao¹,

Fa-jian²,

Liu³

et al. 2021

Ann Palliat Med

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“…On the one hand, thrombin in the hematoma can cause inflammation in the body, affecting endothelial cells, neurons and glial cells and resulting in damage to the blood-brain barrier[ 11 ]; on the other hand, white blood cells and microglia in the body are activated after cerebral hemorrhage, producing a large number of inflammatory factors, and further destroying the blood-brain barrier; thus, there is a vicious cycle created, further aggravating brain tissuedamage[ 12 ]. The endoscopic surgery produces less trauma, and the operation with the cannula does not damage the brain tissue, and the bleeding is arrested under electrocoagulation resulting inhemostasis in the hematoma cavity[ 13 ]. Reducing the occurrence of postoperative bleeding and early and rapid removal of the hematoma is beneficial to patients in order for them to begin rehabilitation.…”

Section: Discussionmentioning

confidence: 99%

Short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage

Wei¹,

Tian²,

Zhang³

et al. 2021

WJCC

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BACKGROUND Hypertensive intracerebral hemorrhage is a common critical disease of the nervous system, comprising one fifth of all acute cerebrovascular diseases and has a high disability and mortality rate. It severely affects the patients’ quality of life. AIM To analyze the short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage. METHODS From March 2018 to May 2020, 118 patients with hypertensive intracerebral hemorrhage were enrolled in our study and divided into a control group and observation group according to the surgical plan. The control group used a hard-channel minimally invasive puncture and drainage procedure. The observation group underwent minimally invasive neuroendoscopic surgery. The changes in the levels of serum P substances (SP), inflammatory factors [tumor necrosis factor-α, interleukin-6 (IL-6), IL-10], and the National Hospital Stroke Scale (NIHSS) and Barthel index scores were recorded. Surgery related indicators and prognosis were compared between the two groups. RESULTS The operation time (105.26 ± 28.35) of the observation group was min longer than that of the control group, and the volume of intraoperative bleeding was 45.36 ± 10.17 mL more than that of the control group. The hematoma clearance rates were 88.58% ± 4.69% and 94.47% ± 4.02% higher than those of the control group at 48 h and 72 h, respectively. Good prognosis rate (86.44%) was higher in the observation group than in the control group, and complication rate (5.08%) was not significantly different from that of the control group ( P > 0.05).The SP level and Barthel index score of the two groups increased ( P < 0.05) and the inflammatory factors and NIHSS score decreased ( P < 0.05). The cytokine levels, NIHSS score, and Barthel index score were better in the observation group than in the control group ( P < 0.05). CONCLUSION Neuroendoscopic minimally invasive surgery is more complicated than hard channel minimally invasive puncture drainage in the treatment of hypertensive intracerebral hemorrhage; however, hematoma clearance is more thorough, and the short-term effect and long-term prognosis are better than hard channel minimally invasive puncture drainage.

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Low diagnostic yield in follow-up MR imaging in patients with spontaneous intracerebral hemorrhage with a negative initial MRI

Cited by 10 publications

References 9 publications

Diagnostic Utility of Brain MRI in Spontaneous Intracerebral Hemorrhage: A Retrospective Cohort Study and Meta-Analysis

Diagnostic Utility of Brain MRI in Spontaneous Intracerebral Hemorrhage: A Retrospective Cohort Study and Meta-Analysis

Correlation analysis between TSP2, MMP-9 and perihematoma edema, as well as the short-term prognosis of patients with hypertensive intracerebral hemorrhage

Short-term effect and long-term prognosis of neuroendoscopic minimally invasive surgery for hypertensive intracerebral hemorrhage

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