Development and validation of a simple conversion model for comparison of intracerebral hemorrhage volumes measured on CT and gradient recalled echo MRI.
OBJECTIVE
Gradient recalled echo MRI (GRE) has been shown to be as accurate as CT for the detection of acute intracerebral hemorrhage (ICH). However, because of the differences in the signal parameter being detected, apparent hemorrhage size is expected to vary by imaging modality, with GRE providing larger volumes attributable to susceptibility effects.


METHODS
Image data from patients participating in 3 ICH studies were retrospectively reviewed. Patients with acute ICH were included if (1) concurrent MRI and CT were performed within 72 hours of symptom onset, and (2) each modality was performed within 240 minutes of each other. ICH volumes were calculated using a semiautomated image analysis program. The least squares method was used to develop a conversion equation based on a linear regression of GRE volume on CT volume.


RESULTS
Thirty-six patients met inclusion criteria. MRI was performed first in 18, CT first in 18. Mean hemorrhage volume was 25.2 cc (range 0.1 to 83.9 cc) on CT and 32.7 cc (range 0.1 to 98.7 cc) measured on GRE. A linear relationship defined by CT Volume=GRE Volume*0.8 (Spearman's correlation coefficient=0.992, P<0.001) was derived.


CONCLUSIONS
Acute ICH volumes as measured on GRE pulse sequences are consistently larger than CT volumes. A simple mathematical conversion model has been developed: CT volume=0.8*GRE volume. This formula can be used in studies using both imaging modalities, across different studies, or to track ICH growth over time independent of imaging modality in an individual patient.
Burgess
Richard E
RE
Department of Neurology, Georgetown University Hospital, 3800 Reservoir Road, NW, 7th Floor PHC Bldg, Washington, DC 20007, USA. burgessri@ninds.nih.gov
Warach
Steven
S
Schaewe
Timothy J
TJ
Copenhaver
Brittany R
BR
Alger
Jeffry R
JR
Vespa
Paul
P
Martin
Neil
N
Saver
Jeffrey L
JL
Kidwell
Chelsea S
CS
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001331:Automation; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000473:pathology*; D017352:Echo-Planar Imaging / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D012044:Regression Analysis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*