Comparison of five MR sequences for the detection of acute intracranial hemorrhage.
OBJECTIVE
To evaluate the respective value of 5 MR sequences to distinguish between stroke patients with and without acute intracerebral hemorrhage (ICH).


METHODS
MR images obtained < or =6 h after stroke onset of 86 patients (43 ICH, 43 non-ICH) were reviewed by 3 observers who looked for signs of acute ICH on each image set [T(1) and T(2) gradient echo (GRE), FLAIR, T(2)-EPI and DWI], presented separately.


RESULTS
For the identification of ICH, intraobserver and interobserver concordance were at least kappa = 0.95 for all sequences. Of all interpretations, 7 (0.4%) were erroneous, with sensitivity and specificity of FLAIR, T(2)-EPI and DWI reaching 100%; GRE sensitivity and specificity were 100% and 95-97.5%, respectively; T(1) sensitivity and specificity were 97.3-100% and 97.4-100%, respectively. All 4 patients misclassified on one pulse sequence were correctly classified on all the other sequences.


CONCLUSIONS
In the setting of acute stroke, each of the 5 studied sequences enables ICH and non-ICH patients to be distinguished with high sensitivity and specificity.
Oppenheim
Catherine
C
Department of Neuroradiology, Sainte-Anne Hospital, Paris V University, France. e.oppenheim@ch-sainte-anne.fr
Touzé
Emmanuel
E
Hernalsteen
Danielle
D
Peeters
André
A
Lamy
Catherine
C
Mas
Jean-Louis
JL
Meder
Jean-François
JF
Cosnard
Guy
G
D000208:Acute Disease; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D020300:Intracranial Hemorrhages / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D020521:Stroke / Q000473:pathology*