Connective tissue reactions in subdural haematomas: imaging with contrast-enhancement MRI.
The sensitivity of contrast enhanced magnetic resonance imaging (MRI) in the detection of connective tissue reactions accompanying the maturation of subdural haematomas (SDH) was studied. An outer enhancing layer between the SDH and the tabula interna of the vault was shown in 16 out of 17 cases. In early SDH this outer enhancing layer presumably is due to vascular congestion and/or increased vascular permeability. A thickening of the outer enhancing layer and/or an inner enhancing layer between the haematoma and the subarachnoid space was visible in 9 patients and represented a haematoma capsule formed by proliferating granulation tissue. In 5 SDH septations were found, 3 SDH consisted almost completely of enhancing granulation tissue. Thus, contrast enhanced MRI delivers additional information about the structure of SDH, which are useful for determining the extent of surgical treatment especially in chronic SDH.
Spreer
J
J
Department of Diagnostic Radiology, Albert-Ludwigs-Universität Freiburg/Brsg, Federal Republic of Germany.
Ernestus
R I
RI
Lanfermann
H
H
Lackner
K
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003240:Connective Tissue Diseases / Q000209:etiology* / Q000473:pathology*; D005260:Female; D006408:Hematoma, Subdural / Q000150:complications* / Q000473:pathology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged