[Comparison of computer tomography and magnetic resonance tomography in the diagnosis of acute intracerebral hemorrhage].
OBJECTIVE
Stroke symptoms are caused in 10 to 15% by intracerebral hemorrhage. From the clinical examination it is often impossible to differentiate intracerebral hemorrhage from cerebral ischemia. To exclude intracerebral hemorrhage as the cause of clinical symptoms a CT is usually performed. The aim of our study was a direct comparison of the sensitivity of Computed Tomography and MRI using different MR sequences for the detection of acute intracerebral hemorrhage.


METHODS
In 8 male Wistar rats intracerebral hemorrhage was induced by infusion of collagenase into the caudate nucleus. After 1hour the brains were subsequently imaged with CT and MRI using T2- and T1-weighted Spin Echo sequences, diffusion-weighted sequences, T2*-weighted gradient echo sequences and FLAIR-sequences. Visibility of the intracerebral hemorrhage was examined using a scoring system from 1 = not visible to 5 = excellent visible. Finally, the intracerebral hemorrhage was verified by histological staining.


RESULTS
In all animals, intracerebral hemorrhage was visible in T2*-weighted gradient echo and diffusion weighted MR images 1 h after infusion of collagenase. T2- and PD-weighted SE images were positive in 7/8 rats. T1-weighted images revealed signal changes in 5/8 rats, and FLAIR sequence was positive in 8/8 rats. In CT intracerebral hemorrhage was only visible in 3/8 rats. When measuring the increase of Hounsfield units within the suspected hemisphere we saw a mean increase of 7% compared to the normal hemisphere in 3/8 rats.


CONCLUSIONS
In this animal model, T2*-weighted magnetic resonance imaging proved to be the most sensitive imaging modality in the detection of acute intracerebral hemorrhage and is by far more sensitive than CT.
Kuhn
S
S
Abteilung Klinische Neuroradiologie der Universität Heidelberg.
Reith
W
W
Ertl-Wagner
B
B
Elste
V
V
Sartor
K
K
D000818:Animals; D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000175:diagnosis / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000473:pathology; D004195:Disease Models, Animal; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D051381:Rats; D020521:Stroke / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D014057:Tomography, X-Ray Computed