title: [The "heme"-sequence (T2*-weighted gradient echo magnetic resonance tomography). Value in differential spontaneous intracerebral hemorrhage diagnosis].
abstract: In four patients presenting with acute non-traumatic intracerebral or intraspinal hemorrhage, T2*-weighted gradient-echo MRI showed numerous residual hemosiderin deposits due to old intracerebral hemorrhages that were missed on initial CT and spin-echo MRI. The demonstration of additional chronic bleedings and their anatomical distribution provided important diagnostic information. In a hypertensive patient, the hemosiderin deposits were most pronounced within deep brain structures suggesting hypertensive cerebral microangiopathy. In a second patient, the cortico-subcortical distribution of the hemorrhages was typical of cerebral amyloid angiopathy. In a third patient, the diffuse distribution including spinal bleeding, the marked calcification, and the characteristic appearance on spin-echo MRI were consistent with multiple cavernomas. In another patient with cerebral and spinal hemorrhage, T2*-weighted gradient-echo MRI revealed new subclinical hemorrhages during follow-up. Based on these findings, we recommend that T2*-weighted gradient-echo MRI of the brain should be performed in all patients with acute intracranial and spinal bleedings.
authors.affiliation: Neurologische Klinik und Poliklinik der Technischen Universität München.
authors.forename: H R
authors.initials: HR
authors.lastname: Siebner
authors.forename: H
authors.initials: H
authors.lastname: Gräflin von Einsiedel
authors.forename: T
authors.initials: T
authors.lastname: Wilhelm
authors.forename: C
authors.initials: C
authors.lastname: Auer
authors.forename: B
authors.initials: B
authors.lastname: Conrad
mesh_terms: D000368:Aged; D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D006418:Heme / Q000032:analysis*; D006485:Hemosiderin / Q000032:analysis; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013116:Spinal Cord / Q000473:pathology
chemical_list: D006418:Heme; D006485:Hemosiderin