B0 images obtained from diffusion-weighted echo planar sequences for the detection of intracerebral bleeds.
OBJECTIVE
To evaluate the accuracy of B0 echo planar imaging (EPI) sequences for the detection of intracerebral bleeds.


METHODS
One hundred patients with acute strokes had magnetic resonance imaging and computed tomography (CT) examinations performed within 48 hours after the onset of symptoms. The detectability of intracerebral bleeds by the B0 EPI sequences was assessed. The results were compared to the gradient echo (GRE) sequence and CT brain examinations. The results of the GRE sequences were used as the gold standard.


RESULTS
The B0 EPI sequences detected 11 out of 11 acute, intracerebral hematomas; 6 out of 8 acute hemorrhagic strokes; 2 out of 2 acute, intraventricular hemorrhages; 8 out of 8 old hemorrhagic infarcts; 1 out of 1 subarachnoid hemorrhages; and 11 out of 22 patients with microbleeds. For the detection of acute, intracerebral hematomas and acute, hemorrhagic infarcts, B0 EPI sequences had a sensitivity of 89.5%, a specificity of 100%, and an accuracy of 98%. CT had a sensitivity of 57.9%, a specificity of 100%, and an accuracy of 92%. B0 EPI sequences did not miss any acute or chronic hemorrhages detected by CT examinations.


CONCLUSIONS
B0 EPI sequences could not replace GRE images for the detection of both acute and chronic hemorrhages. Their sensitivity for the detection of acute and chronic blood products, however, was comparable, if not superior, to that of CT examinations.
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Chinese University of Hong Kong, Ngan Shing Street, Shatin, New Territories, Hong Kong. wynnie@cuhk.edu.hk
W W M
WW
Lam
N M C
NM
So
K S
KS
Wong
T
T
Rainer
D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D017352:Echo-Planar Imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed