American Journal of Neuroradiology 20:629-636 (4 1999)
© 1999 American Society of Neuroradiology
ARTICLE
Fluid-Attenuated Inversion-Recovery MR Imaging in Acute and Subacute Cerebral Intraventricular Hemorrhage
a From the Dent Neurologic Institute, Lucy Dent Imaging Center, Kaleida Health System, Millard Fillmore Hospital, State University of NY, Buffalo, NY.
BACKGROUND AND PURPOSE: Fluid-attenuated inversion-recovery (FLAIR) MR imaging may show subarachnoid hemorrhage (SAH) with high sensitivity. We hypothesized that the FLAIR technique is effective and reliable in the diagnosis of cerebral intraventricular hemorrhage (IVH).
METHODS: Two observers evaluated the 1.5-T MR fast spin-echo FLAIR images, T1- and T2-weighted MR images, and CT scans of 13 patients with IVH and the FLAIR images of 40 control subjects.
RESULTS: IVH appeared bright on the FLAIR images obtained during the first 48 hours and was of variable appearance at later stages. FLAIR MR imaging detected 12 of 13 cases of IVH; no control subjects were falsely thought to have IVH (92% sensitivity, 100% specificity). However, IVH could not be fully excluded in the third ventricle (20%, n = 8) or in the fourth ventricle (28%, n = 11) on some control images because of CSF pulsation artifacts. Two cases had CT-negative IVH seen on FLAIR images. One case had FLAIR-negative IVH seen by CT. Although the sensitivities of conventional MR imaging (92%) and CT (85%) were also high, FLAIR imaging showed IVH more conspicuously than did standard MR imaging and CT in 62% of the cases (n = 8). FLAIR was as good as or better than CT in showing IVH in 10 cases (77%). FLAIR images showed all coexisting SAH.
CONCLUSION: FLAIR MR imaging identifies acute and subacute IVH in the lateral ventricles with high sensitivity and specificity. In cases of subacute IVH, conventional MR imaging complements FLAIR in detecting IVH. The usefulness of the FLAIR technique for detecting third and fourth ventricular IVH may be compromised by artifacts. Blood hemoglobin degradation most likely causes the variable FLAIR appearance of IVH after the first 48 hours.
This article has been cited by other articles:
 |
|
 |
|
  S. Yamada, M. Miyazaki, H. Kanazawa, M. Higashi, Y. Morohoshi, S. Bluml, and J. G. McComb Visualization of Cerebrospinal Fluid Movement with Spin Labeling at MR Imaging: Preliminary Results in Normal and Pathophysiologic Conditions Radiology, November 1, 2008; 249(2): 644 - 652. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. L. Stuckey, T. D. Goh, T. Heffernan, and D. Rowan Hyperintensity in the Subarachnoid Space on FLAIR MRI Am. J. Roentgenol., October 1, 2007; 189(4): 913 - 921. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Cianfoni, M.G.M. Martin, J. Du, J.R. Hesselink, S.G. Imbesi, W.G. Bradley, and G.M. Bydder Artifact simulating subarachnoid and intraventricular hemorrhage on single-shot, fast spin-echo fluid-attenuated inversion recovery images caused by head movement: A trap for the unwary. AJNR Am. J. Neuroradiol., April 1, 2006; 27(4): 843 - 849. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C.-H. Sohn, S.-K. Baik, H.-J. Lee, S.-M. Lee, I.-M. Kim, M.-B. Yim, J.-S. Hwang, M. L. Lauzon, and R. J. Sevick MR Imaging of Hyperacute Subarachnoid and Intraventricular Hemorrhage at 3T: A Preliminary Report of Gradient Echo T2*-Weighted Sequences AJNR Am. J. Neuroradiol., March 1, 2005; 26(3): 662 - 665. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Mohamed, D. C. Heasely, B. Yagmurlu, and D. M. Yousem Fluid-Attenuated Inversion Recovery MR Imaging and Subarachnoid Hemorrhage: Not a Panacea AJNR Am. J. Neuroradiol., April 1, 2004; 25(4): 545 - 550. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Saleh, F Wenserski, M Cohnen, G Furst, E Godehardt, and U Modder Exclusion of brain lesions: is MR contrast medium required after a negative fluid-attenuated inversion recovery sequence? Br. J. Radiol., March 1, 2004; 77(915): 183 - 188. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. A. Pezzullo, G. A. Tung, S. Mudigonda, and J. M. Rogg Diffusion-Weighted MR Imaging of Pyogenic Ventriculitis Am. J. Roentgenol., January 1, 2003; 180(1): 71 - 75. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D J A Connolly, D Birchall, and A Gholkar Current theory in imaging of intracranial vascular disease Imaging, October 1, 2002; 14(5): 396 - 408. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Makkat, J. E. Vandevenne, G. Verswijvel, T. Ijsewijn, M. Grieten, Y. Palmers, A. M. De Schepper, and P. M. Parizel Signs of Acute Stroke Seen on Fluid-Attenuated Inversion Recovery MR Imaging Am. J. Roentgenol., July 1, 2002; 179(1): 237 - 243. [Full Text] [PDF]
|
|
|
|
|
|
H.-M. Wu, D. M. Yousem, H.-W. Chung, W.-Y. Guo, C.-Y. Chang, and C.-Y. Chen Influence of Imaging Parameters on High-Intensity Cerebrospinal Fluid Artifacts in Fast-FLAIR MR Imaging AJNR Am. J. Neuroradiol., March 1, 2002; 23(3): 393 - 399. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. F. Kallmes, F. K. Hui, and J. P. Mugler III Suppression of Cerebrospinal Fluid and Blood Flow Artifacts in FLAIR MR Imaging with a Single-Slab Three-dimensional Pulse Sequence: Initial Experience Radiology, October 1, 2001; 221(1): 251 - 255. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Bakshi, S. Ariyaratana, R. H. B. Benedict, and L. Jacobs Fluid-Attenuated Inversion Recovery Magnetic Resonance Imaging Detects Cortical and Juxtacortical Multiple Sclerosis Lesions Arch Neurol, May 1, 2001; 58(5): 742 - 748. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Taoka, W. T. C. Yuh, M. L. White, J. P. Quets, J. E. Maley, and T. Ueda Sulcal Hyperintensity on Fluid-Attenuated Inversion Recovery MR Images in Patients Without Apparent Cerebrospinal Fluid Abnormality Am. J. Roentgenol., February 1, 2001; 176(2): 519 - 524. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Bakshi, S. Warach, and W. Hacke Diffusion-weighted MRI as an evolving standard of care in acute stroke Neurology, November 28, 2000; 55(10): 1595 - 1595. [Full Text] [PDF]
|
|
|
|
|
|
R. Bakshi, M. F. Morcos, T. F. Gabryel, and P. Dandona Is fluid-attenuated inversion recovery MRI more sensitive than conventional MRI for hypoglycemic brain injury? Neurology, October 10, 2000; 55(7): 1064 - 1065. [Full Text] [PDF]
|
|
|
|
|
|
V. Janardhan and R. Bakshi Quality of Life and Its Relationship to Brain Lesions and Atrophy on Magnetic Resonance Images in 60 Patients With Multiple Sclerosis Arch Neurol, October 1, 2000; 57(10): 1485 - 1491. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Bakshi, S. D. Caruthers, V. Janardhan, and M. Wasay Intraventricular CSF Pulsation Artifact on Fast Fluid-Attenuated Inversion-Recovery MR Images: Analysis of 100 Consecutive Normal Studies AJNR Am. J. Neuroradiol., March 1, 2000; 21(3): 503 - 508. [Abstract] [Full Text]
|
|