Stroke magnetic resonance imaging is accurate in hyperacute intracerebral hemorrhage: a multicenter study on the validity of stroke imaging.

Abstract:

BACKGROUND AND PURPOSE:Although modern multisequence stroke MRI protocols are an emerging imaging routine for the diagnostic assessment of acute ischemic stroke, their sensitivity for intracerebral hemorrhage (ICH), the most important differential diagnosis, is still a matter of debate. We hypothesized that stroke MRI is accurate in the detection of ICH. To evaluate our hypotheses, we conducted a prospective multicenter trial. METHODS:Stroke MRI protocols of 6 university hospitals were standardized. Images from 62 ICH patients and 62 nonhemorrhagic stroke patients, all imaged within the first 6 hours after symptom onset (mean, 3 hours 18 minutes), were analyzed. For diagnosis of hemorrhage, CT served as the "gold standard." Three readers experienced in stroke imaging and 3 final-year medical students, unaware of clinical details, separately evaluated sets of diffusion-, T2-, and T2*-weighted images. The extent and phenomenology of the hemorrhage on MRI were assessed separately. RESULTS:Mean patient age was 65.5 years; median National Institutes of Health Stroke Scale score was 10. The experienced readers identified ICH with 100% sensitivity (confidence interval, 97.1 to 100) and 100% overall accuracy. Mean ICH size was 17.3 mL (range, 1 to 101.5 mL). The students reached a mean sensitivity of 95.16% (confidence interval, 90.32 to 98.39). CONCLUSIONS:Hyperacute ICH causes a characteristic imaging pattern on stroke MRI and is detectable with excellent accuracy. Even raters with limited film-reading experience reached good accuracy. Stroke MRI alone can rule out ICH and demonstrate the underlying pathology in hyperacute stroke.

journal_name

Stroke

journal_title

Stroke

authors

Fiebach JB,Schellinger PD,Gass A,Kucinski T,Siebler M,Villringer A,Olkers P,Hirsch JG,Heiland S,Wilde P,Jansen O,Röther J,Hacke W,Sartor K,Kompetenznetzwerk Schlaganfall B5.

doi

10.1161/01.STR.0000114203.75678.88

subject

Has Abstract

pub_date

2004-02-01 00:00:00

pages

502-6

issue

2

eissn

0039-2499

issn

1524-4628

pii

01.STR.0000114203.75678.88

journal_volume

35

pub_type

临床试验,杂志文章,多中心研究

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