Detection of hyperacute subarachnoid hemorrhage of the brain by using magnetic resonance imaging.
OBJECTIVE
The purpose of this study was to determine the diagnostic accuracy of high-field (1.5-tesla) magnetic resonance (MR) imaging in the assessment of hyperacute (< 12 hours after onset of symptoms) subarachnoid hemorrhage (SAH).


METHODS
This investigation included 13 patients who were examined 2 to 12 hours posthemorrhage by using an MR imaging protocol consisting of T2-weighted and proton-density (PD)-weighted images, T1-weighted images, fast echoplanar-diffusion-weighted (EP-DW) images, and fluid-attenuated inversion-recovery (FLAIR) images. Subarachnoid hemorrhage had been diagnosed using computerized tomography (CT) scanning in all cases. In all 13 cases, SAH was reliably detected on both PD-weighted and FLAIR images. In contrast with FLAIR studies, the PD-weighted images were free of cerebrospinal fluid flow artifacts. The SAH was detected on T1-weighted images in only two cases and could not be detected on any T2-weighted or EP-DW images.


CONCLUSIONS
Even hyperacute SAH can be diagnosed reliably from high-field MR images obtained using PD-weighted or FLAIR sequences. Use of these sequences in an emergency MR protocol may preclude the need for additional CT studies to rule out SAH.
Wiesmann
Martin
M
Department of Radiology, Medical University, Luebeck, Germany. wiesmann@medinf.mu-luebeck.de
Mayer
Thomas E
TE
Yousry
Indra
I
Medele
Ralph
R
Hamann
Gerhard F
GF
Brückmann
Hartmut
H
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D013345:Subarachnoid Hemorrhage / Q000473:pathology*; D013997:Time Factors