The value of magnetic resonance imaging for the detection of the bleeding source in non-traumatic intracerebral haemorrhages: a comparison with conventional digital subtraction angiography
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The value of magnetic resonance imaging for the detection of the bleeding source in non-traumatic intracerebral haemorrhages: a comparison with conventional digital subtraction angiography:
Abstract
Introduction
Conventional digital subtraction angiography (DSA) is currently regarded as the gold standard in detecting underlying vascular
pathologies in patients with intracerebral haemorrhages (ICH). However, the use of magnetic resonance imaging (MRI) in the
diagnostic workup of ICHs has considerably increased in recent years. Our aim was to evaluate the diagnostic accuracy and
yield of MRI for the detection of the underlying aetiology in ICH patients.
pathologies in patients with intracerebral haemorrhages (ICH). However, the use of magnetic resonance imaging (MRI) in the
diagnostic workup of ICHs has considerably increased in recent years. Our aim was to evaluate the diagnostic accuracy and
yield of MRI for the detection of the underlying aetiology in ICH patients.
Methods
Sixty-seven consecutive patients with an acute ICH who underwent MRI (including magnetic resonance angiography (MRA) and DSA
during their diagnostic workup) were included in the study. Magnetic resonance images were retrospectively analysed by two
independent neuroradiologists to determine the localisation and cause of the ICH. DSA was used as a reference standard.
during their diagnostic workup) were included in the study. Magnetic resonance images were retrospectively analysed by two
independent neuroradiologists to determine the localisation and cause of the ICH. DSA was used as a reference standard.
Results
In seven patients (10.4%), a DSA-positive vascular aetiology was present (one aneurysm, four arteriovenous malformations,
one dural arteriovenous fistula and one vasculitis). All of these cases were correctly diagnosed by both readers on MRI. In
addition, MRI revealed the following probable bleeding causes in 39 of the 60 DSA-negative patients: cerebral amyloid angiopathy
(17), cavernoma (9), arterial hypertension (8), haemorrhagic transformation of an ischaemic infarction (3) and malignant brain
tumour with secondary ICH (2).
one dural arteriovenous fistula and one vasculitis). All of these cases were correctly diagnosed by both readers on MRI. In
addition, MRI revealed the following probable bleeding causes in 39 of the 60 DSA-negative patients: cerebral amyloid angiopathy
(17), cavernoma (9), arterial hypertension (8), haemorrhagic transformation of an ischaemic infarction (3) and malignant brain
tumour with secondary ICH (2).
Conclusion
Performing MRI with MRA proved to be an accurate diagnostic tool in detecting vascular malformations in patients with ICH.
In addition, MRI provided valuable information regarding DSA-negative ICH causes, and thus had a high diagnostic yield in
ICH patients.
In addition, MRI provided valuable information regarding DSA-negative ICH causes, and thus had a high diagnostic yield in
ICH patients.
- Content Type Journal Article
- Category Diagnostic Neuroradiology
- Pages 1-8
- DOI 10.1007/s00234-011-0953-0
- Authors
- Nina Lummel, Department of Neuroradiology, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany
- Jürgen Lutz, Department of Neuroradiology, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany
- Hartmut Brückmann, Department of Neuroradiology, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany
- Jennifer Linn, Department of Neuroradiology, University of Munich, Marchioninistrasse 15, 81377 Munich, Germany
- Journal Neuroradiology
- Online ISSN 1432-1920
- Print ISSN 0028-3940
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