MR diagnosis of subacute and chronic subarachnoid hemorrhage: comparison with CT

• Published in: American journal of roentgenology (1976) Vol. 165; no. 5; pp. 1257 - 1262
• Main Authors: Ogawa, T, Inugami, A, Fujita, H, Hatazawa, J, Shimosegawa, E, Noguchi, K, Okudera, T, Kanno, I, Uemura, K, Suzuki, A
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.11.1995; American Roentgen Ray Society
• Subjects: Acute Disease; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Brain - diagnostic imaging; Brain - pathology; Chronic Disease; Female; Humans; Magnetic Resonance Imaging; Male; Medical sciences; Middle Aged; Neurology; Subarachnoid Hemorrhage - diagnosis; Subarachnoid Hemorrhage - diagnostic imaging; Tomography, X-Ray Computed; Vascular diseases and vascular malformations of the nervous system; Human; Nervous system diseases; Radiodiagnosis; Cardiovascular disease; Exploration; Hemorrhage; Nuclear magnetic resonance imaging; Cerebral disorder; Vascular disease; Chronic; Computerized axial tomography; Cerebrovascular disease; Comparative study
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/ajr.165.5.7572514

The purpose of our study was to compare the value of MR imaging with CT in the diagnosis of subarachnoid hemorrhage in the subacute and chronic stages (> 3 days after the hemorrhagic episode). We performed 42 MR examinations using a 0.5-T unit in 37 patients with subarachnoid hemorrhage caused by a ruptured aneurysm. Examinations were done 4-75 days after the ictus. We obtained 40 T1-weighted, 11 proton density-weighted, 15 T2-weighted, and 28 moderately T2-weighted images. CT was also performed in all patients within 24 hr of the MR examination. Confirmation of the presence of subarachnoid hemorrhage at the time of the MR examination was made by CSF examination using lumbar puncture or surgical findings. In the subacute and chronic stages, subarachnoid hemorrhage was seen as an area of high signal intensity on T1-weighted, proton density-weighted, T2-weighted, and moderately T2-weighted MR images in 63%, 90%, 25%, and 92% of cases, respectively. On CT scans, subarachnoid hemorrhage was seen as an area of high attenuation in only 46% of cases. Especially in the chronic stage, subarachnoid hemorrhage was seen as an area of high signal intensity more frequently by MR imaging than by CT (90% on T1-weighted images; 100% on proton density-weighted images; 25% on T2-weighted images; 100% on moderately T2-weighted images; and 10% on CT scans). High-signal-intensity subarachnoid hemorrhage was demonstrated by MR imaging until a maximum of 39 days after the ictus, whereas high-attenuation subarachnoid hemorrhage was demonstrated by CT until a maximum of 17 days after the ictus. Our findings show that MR imaging is superior to CT for the diagnosis of subacute and chronic subarachnoid hemorrhage. MR imaging is especially useful for the diagnosis of chronic subarachnoid hemorrhage.