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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 2001 Feb;70(2):205–211. doi: 10.1136/jnnp.70.2.205

Detection of subarachnoid haemorrhage with magnetic resonance imaging

P Mitchell 1, I Wilkinson 1, N Hoggard 1, M Paley 1, D Jellinek 1, T Powell 1, C Romanowski 1, T Hodgson 1, P Griffiths 1
PMCID: PMC1737199  PMID: 11160469

Abstract

OBJECTIVES—To measure the sensitivity and specificity of five MRI sequences to subarachnoid haemorrhage.
METHODS—Forty one patients presenting with histories suspicious of subarachnoid haemorrhage (SAH) were investigated with MRI using T1 weighted, T2 weighted, single shot fast spin echo (express), fluid attenuation inversion recovery (FLAIR), and gradient echo T2* sequences, and also by CT. Lumbar puncture was performed in cases where CT was negative for SAH. Cases were divided into acute (scanned within 4 days of the haemorrhage) and subacute (scanned after 4 days) groups.
RESULTS—The gradient echo T2* was the most sensitive sequence, with sensitivities of 94% in the acute phase and 100% in the subacute phase. Next most sensitive was FLAIR with values of 81% and 87% for the acute and subacute phases respectively. Other sequences were considerably less sensitive.
CONCLUSIONS—MRI can be used to detect subacute and acute subarachnoid haemorrhage and has significant advantages over CT in the detection of subacute subarachnoid haemorrhage. The most sensitive sequence was the gradient echo T2*.



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Selected References

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  1. Chrysikopoulos H., Papanikolaou N., Pappas J., Papandreou A., Roussakis A., Vassilouthis J., Andreou J. Acute subarachnoid haemorrhage: detection with magnetic resonance imaging. Br J Radiol. 1996 Jul;69(823):601–609. doi: 10.1259/0007-1285-69-823-601. [DOI] [PubMed] [Google Scholar]
  2. Kates R., Atkinson D., Brant-Zawadzki M. Fluid-attenuated inversion recovery (FLAIR): clinical prospectus of current and future applications. Top Magn Reson Imaging. 1996 Dec;8(6):389–396. [PubMed] [Google Scholar]
  3. Mikami T., Saito K., Okuyama T., Sakamoto Y., Takahashi A., Shibata K. [FLAIR images of subarachnoid hemorrhage]. No Shinkei Geka. 1996 Dec;24(12):1087–1092. [PubMed] [Google Scholar]
  4. Morgenstern L. B., Luna-Gonzales H., Huber J. C., Jr, Wong S. S., Uthman M. O., Gurian J. H., Castillo P. R., Shaw S. G., Frankowski R. F., Grotta J. C. Worst headache and subarachnoid hemorrhage: prospective, modern computed tomography and spinal fluid analysis. Ann Emerg Med. 1998 Sep;32(3 Pt 1):297–304. [PubMed] [Google Scholar]
  5. Noguchi K., Ogawa T., Inugami A., Toyoshima H., Okudera T., Uemura K. MR of acute subarachnoid hemorrhage: a preliminary report of fluid-attenuated inversion-recovery pulse sequences. AJNR Am J Neuroradiol. 1994 Nov;15(10):1940–1943. [PMC free article] [PubMed] [Google Scholar]
  6. Noguchi K., Ogawa T., Inugami A., Toyoshima H., Sugawara S., Hatazawa J., Fujita H., Shimosegawa E., Kanno I., Okudera T. Acute subarachnoid hemorrhage: MR imaging with fluid-attenuated inversion recovery pulse sequences. Radiology. 1995 Sep;196(3):773–777. doi: 10.1148/radiology.196.3.7644642. [DOI] [PubMed] [Google Scholar]
  7. Noguchi K., Ogawa T., Seto H., Inugami A., Hadeishi H., Fujita H., Hatazawa J., Shimosegawa E., Okudera T., Uemura K. Subacute and chronic subarachnoid hemorrhage: diagnosis with fluid-attenuated inversion-recovery MR imaging. Radiology. 1997 Apr;203(1):257–262. doi: 10.1148/radiology.203.1.9122404. [DOI] [PubMed] [Google Scholar]
  8. Ogawa T., Inugami A., Fujita H., Hatazawa J., Shimosegawa E., Noguchi K., Okudera T., Kanno I., Uemura K., Suzuki A. MR diagnosis of subacute and chronic subarachnoid hemorrhage: comparison with CT. AJR Am J Roentgenol. 1995 Nov;165(5):1257–1262. doi: 10.2214/ajr.165.5.7572514. [DOI] [PubMed] [Google Scholar]
  9. Sidman R., Connolly E., Lemke T. Subarachnoid hemorrhage diagnosis: lumbar puncture is still needed when the computed tomography scan is normal. Acad Emerg Med. 1996 Sep;3(9):827–831. doi: 10.1111/j.1553-2712.1996.tb03526.x. [DOI] [PubMed] [Google Scholar]
  10. Singer M. B., Atlas S. W., Drayer B. P. Subarachnoid space disease: diagnosis with fluid-attenuated inversion-recovery MR imaging and comparison with gadolinium-enhanced spin-echo MR imaging--blinded reader study. Radiology. 1998 Aug;208(2):417–422. doi: 10.1148/radiology.208.2.9680570. [DOI] [PubMed] [Google Scholar]
  11. Vermeulen M., Hasan D., Blijenberg B. G., Hijdra A., van Gijn J. Xanthochromia after subarachnoid haemorrhage needs no revisitation. J Neurol Neurosurg Psychiatry. 1989 Jul;52(7):826–828. doi: 10.1136/jnnp.52.7.826. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Vermeulen M., van Gijn J. The diagnosis of subarachnoid haemorrhage. J Neurol Neurosurg Psychiatry. 1990 May;53(5):365–372. doi: 10.1136/jnnp.53.5.365. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Vymazal J., Brooks R. A., Baumgarner C., Tran V., Katz D., Bulte J. W., Bauminger R., Di Chiro G. The relation between brain iron and NMR relaxation times: an in vitro study. Magn Reson Med. 1996 Jan;35(1):56–61. doi: 10.1002/mrm.1910350108. [DOI] [PubMed] [Google Scholar]
  14. van Gijn J., van Dongen K. J. Computed tomography in the diagnosis of subarachnoid haemorrhage and ruptured aneurysm. Clin Neurol Neurosurg. 1980;82(1):11–24. doi: 10.1016/0303-8467(80)90055-4. [DOI] [PubMed] [Google Scholar]
  15. van Gijn J., van Dongen K. J. The time course of aneurysmal haemorrhage on computed tomograms. Neuroradiology. 1982;23(3):153–156. doi: 10.1007/BF00347559. [DOI] [PubMed] [Google Scholar]

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