title: Double inversion recovery MR sequence for the detection of subacute subarachnoid hemorrhage.
abstract: OBJECTIVE
  The diagnosis of subacute subarachnoid hemorrhage is important because rebleeding may occur with subsequent life-threatening hemorrhage. Our aim was to determine the sensitivity of the 3D double inversion recovery sequence compared with CT, 2D and 3D FLAIR, 2D T2*, and 3D SWI sequences for the detection of subacute SAH.
  
  
  METHODS
  This prospective study included 25 patients with a CT-proved acute SAH. Brain imaging was repeated between days 14 and 16 (mean, 14.75 days) after clinical onset and included MR imaging (2D and 3D FLAIR, 2D T2*, SWI, and 3D double inversion recovery) after CT (median delay, 3 hours; range, 2-5 hours). A control group of 20 healthy volunteers was used for comparison. MR images and CT scans were analyzed independently in a randomized order by 3 blinded readers. For each subject, the presence or absence of hemorrhage was assessed in 4 subarachnoid areas (basal cisterns, Sylvian fissures, interhemispheric fissure, and convexity) and in brain ventricles. The diagnosis of subacute SAH was defined by the presence of at least 1 subarachnoid area with hemorrhage.
  
  
  RESULTS
  For the diagnosis of subacute SAH, the double inversion recovery sequence had a higher sensitivity compared with CT (P < .001), 2D FLAIR (P = .005), T2* (P = .02), SWI, and 3D FLAIR (P = .03) sequences. Hemorrhage was present for all patients in the interhemispheric fissure on double inversion recovery images, while no signal abnormality was noted in healthy volunteers. Interobserver agreement was excellent with double inversion recovery.
  
  
  CONCLUSIONS
  Our study showed that the double inversion recovery sequence has a higher sensitivity for the detection of subacute SAH than CT, 2D or 3D FLAIR, 2D T2*, and SWI.
authors.affiliation: From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.) Department of Radiology (J.H., M.Z.), Hôpital Saint Joseph, Paris, France Jerome.hodel@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Hodel
authors.affiliation: Neurosurgery (R.A., J.-P.L.), Hôpital Roger Salengro, Lille, France.
authors.forename: R
authors.initials: R
authors.lastname: Aboukais
authors.affiliation: From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.).
authors.forename: B
authors.initials: B
authors.lastname: Dutouquet
authors.affiliation: From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.).
authors.forename: E
authors.initials: E
authors.lastname: Kalsoum
authors.affiliation: Institut National De La Santé et De La Recherche Médicale (M.A.B.), Centre for Research in Epidemiology and Population Health, Villejuif, France.
authors.forename: M A
authors.initials: MA
authors.lastname: Benadjaoud
authors.affiliation: Philips Medical Systems (D.C.), Suresnes, France.
authors.forename: D
authors.initials: D
authors.lastname: Chechin
authors.affiliation: Department of Radiology (J.H., M.Z.), Hôpital Saint Joseph, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Zins
authors.affiliation: Department of Radiology (A.R., A.L.), Centre Hospitalier Universitaire, Henri Mondor, Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Rahmouni
authors.affiliation: Department of Radiology (A.R., A.L.), Centre Hospitalier Universitaire, Henri Mondor, Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Luciani
authors.affiliation: From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.).
authors.forename: J-P
authors.initials: JP
authors.lastname: Pruvo
authors.affiliation: Neurosurgery (R.A., J.-P.L.), Hôpital Roger Salengro, Lille, France.
authors.forename: J-P
authors.initials: JP
authors.lastname: Lejeune
authors.affiliation: From the Departments of Neuroradiology (J.H., B.D., E.K., J.-P.P., X.L.).
authors.forename: X
authors.initials: X
authors.lastname: Leclerc
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013345:Subarachnoid Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods