Detection of Intracranial Hemorrhage: Comparison between Gradient-echo Images and b0 Images Obtained from Diffusion-weighted Echo-planar Sequences
Doris D. M. Lina,
Christopher G. Filippia,
Alex B. Steevera and
Robert D. Zimmermana
a From the Department of Radiology, New York Presbyterian Hospital, New York, NY (D.D.M.L., C.G.F., R.D.Z.) and the Weill Medical College of Cornell University, New York, NY (A.B.S.).
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FIG 1. A–C, DWI (10000/102/1, b value of 1000) (A), b0 EPI (DWI without diffusion gradients, 10000/102/1) (B), and GRE (425/15/1, 20° flip angle) (C) MR images of acute hemorrhagic infarction involving the left occipital lobe. The infarction is hyperintense on the DWI scan (A) with central hypointensity reflecting hemorrhage. Hypointensity is well depicted on the b0 (B) and GRE (C) sequences
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FIG 2. A–C, DWI scan (A) shows acute (hyperintense) infarction in the left frontal region. On b0 EPI sequence (B) the infarction is relatively hyperintense but somewhat heterogeneous in intensity (scored as negative for hemorrhage on blinded review). The GRE scan (C) clearly shows a hypointense hemorrhagic component within the infarction
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FIG 3. A–C, DWI scan (A) shows acute infarction involving the left cerebellar hemisphere, which appears iso- to hyperintense on the b0 EPI scan (B). A focus of prominent hypointensity indicative of hemorrhage is seen in the medial portion of the infarction (vermis) on the GRE image (C)
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FIG 4. A–C, DWI san (A) at the level of the atria of the lateral ventricles reveals areas of acute (hyperintense) infarction in the frontoparietal region and an area of relative hypointensity due to encephalomalacia in the left frontal lobe. On the b0 EPI scan (B) the old infarction is hyperintense. Note hypointensity on both the DWI (A) and b0 EPI (B) scans in the right periatrial region, indicative of chronic hematoma. GRE scan (C) reveals multiple punctate foci of hemosiderin deposition that are not apparent on any other pulse sequences. The right periatrial hematoma is hypointense.
D–F, DWI (D), b0 (E), and GRE (F) images at the level of the foramen of Monro reveal a chronic right thalamic hematoma, which is hypointense on all pulse sequences; however, the numerous foci of hypointensity are seen only on the GRE scan (F).
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