MR Images of 74-Year-Old Man with History of Recent Intracerebral Hemorrhage
Figures 1, 2. Axial (1) T2-weighted fast spin-echo image (5,500/128) obtained with two signals averaged, 6-mm section thickness, echo train of 23, and 230 × 512 matrix, and (2) T1-weighted unenhanced spin-echo image (520/14) obtained with two signals averaged, 6-mm section thickness, and 173 × 256 matrix.
Figures 3, 4. (3) Axial diffusion-weighted (x sensitizing direction) multishot echo-planar image (800/123) obtained with one signal acquisition and 6-mm section thickness, and (4) corresponding ADC map. On both images, there is important signal loss due to dephasing of spins by deoxyhemoglobin. The high signal intensity (arrow) around the hematoma may be consistent with cytotoxic edema.
Hemorrhage
Diffusion-weighted and T2-weighted echo-planar images are also exquisitely sensitive to hemorrhage and may be used to detect and distinguish between acute hemorrhagic and nonhemorrhagic stroke. Decreased ADC was demonstrated in both acute hemorrhagic and in nonhemorrhagic stroke. However, in contrast to patients with nonhemorrhagic stroke, whose lesions were iso- or hyperintense on T2-weighted echo-planar images, lesions in patients with hemorrhagic stroke were of mixed hypo- and hyperintensity on T2-weighted echo-planar images (1).
References
1. Ebisu T, Tanaka C, Umeda M, et al. Hemorrhagic and nonhemorrhagic stroke: diagnosis with diffusion-weighted and T2-weighted echo-planar MR imaging. Radiology 1997; 203:823-828.
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