Detection of hemosiderin deposition by T2*-weighted MRI after subarachnoid hemorrhage.
OBJECTIVE
Subarachnoid hemorrhage (SAH) is very difficult to diagnose several months after its onset. We thus investigated subarachnoid hemosiderin deposition well after SAH by T2*-weighted MRI, a sensitive method for hemosiderin detection.


METHODS
To investigate how hemosiderin deposition as confirmed by T2*-weighted MRI contributes to the determination of prior SAH and how the extent of hemosiderin deposition is associated with a number of clinical factors, we retrospectively analyzed 58 patients >3 months after SAH associated with ruptured aneurysms. We also investigated 209 healthy volunteers as controls.


RESULTS
T2*-weighted MRI demonstrated subarachnoid hemosiderin deposition in 72.4% of the SAH patients, whereas no deposition was seen in the healthy volunteer group. The hemosiderin was preferentially deposited in the subarachnoid space near a ruptured aneurysm. Odds ratios (ORs) were estimated from logistic regression analyses correlating hemosiderin deposition with other factors. Age (>or=54 years) (OR, 5.1; 95% CI, 1.03 to 25.0; P=0.046), Fisher grade 3 on initial CT (OR, 8.0; 95% CI, 1.26 to 50.4; P=0.027), and Karnofsky Scale score <or=80% 6 months after onset of SAH (OR, 12.8; 95% CI, 1.97 to 83.3; P=0.0077) were all found to be independently associated with hemosiderin deposition levels.


CONCLUSIONS
T2*-weighted MRI is an effective means of diagnosing prior SAH and may also reveal the location of a ruptured aneurysm. The extent of hemosiderin deposition was significantly associated with several factors, including age, CT findings, and poor prognosis.
Imaizumi
Toshio
T
Department of Neurosurgery, Hakodate Municipal Hospital, Hokkaido, Japan. timaizum@d9.dion.ne.ip
Chiba
Masahiko
M
Honma
Toshimi
T
Niwa
Jun
J
D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006485:Hemosiderin / Q000032:analysis* / Q000378:metabolism*; D006801:Humans; D016015:Logistic Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed
D006485:Hemosiderin