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Abstract

MR Imaging of Hemorrhagic Intracranial Neoplasms

Sylvie Destian, Gordon Sze, George Krol, Robert D. Zimmerman and Michael D. F. Deck
American Journal of Neuroradiology November 1988, 9 (6) 1115-1122;
Sylvie Destian
1Department of Radiology, Cornell University Medical Center and New York Hospital, 525 E. 68th St., New York, NY 10021
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Gordon Sze
2Department of Medical Imaging, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021. Address reprint requests to G. Sze
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George Krol
2Department of Medical Imaging, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021. Address reprint requests to G. Sze
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Robert D. Zimmerman
1Department of Radiology, Cornell University Medical Center and New York Hospital, 525 E. 68th St., New York, NY 10021
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Michael D. F. Deck
1Department of Radiology, Cornell University Medical Center and New York Hospital, 525 E. 68th St., New York, NY 10021
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Abstract

Thirty patients with intracranial tumors containing hemorrhage of varying stages were examined with high-field-strength MR imaging and CT to determine what differences might exist between hemorrhagic tumor and pure hemorrhage. Pathology was obtained in the six patients with primary tumors and in 14 of the 24 patients with metastases. Similar to evolving intraparenchymal hematomas, hemorrhagic neoplasms undergo changes in their appearance that can be categorized into three distinct intensity patterns, or stages. Stage 1 is characterized as iso- or hypointensity on short TR sequences and as hypointensity on long TR sequences; stage 2 as developing hyperintensity on both short and long TR sequences, without evidence of a well-defined black rim; and stage 3 as a hyperintense lesion with a well-defined black rim on long TR sequences. An additional mixed-intensity pattern was identified, which contained areas corresponding to more than one stage. In all of the cases exhibiting this pattern, pathology confirmed that the appearance was due to recurrent bleeding. We found several characteristics on MR that, when present, suggest an underlying neoplasm. These include delay in evolution between stages, central or eccentric hyperintensity in stage 2, and a mixed-intensity pattern. In addition, the presence of a hemosiderin rim does not exclude an underlying neoplasm.

We found that the MR patterns that characterize hemorrhagic intracranial neoplasms should help to determine the cause of the hemorrhage.

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American Journal of Neuroradiology
Vol. 9, Issue 6
1 Nov 1988
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MR Imaging of Hemorrhagic Intracranial Neoplasms
Sylvie Destian, Gordon Sze, George Krol, Robert D. Zimmerman, Michael D. F. Deck
American Journal of Neuroradiology Nov 1988, 9 (6) 1115-1122;

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MR Imaging of Hemorrhagic Intracranial Neoplasms
Sylvie Destian, Gordon Sze, George Krol, Robert D. Zimmerman, Michael D. F. Deck
American Journal of Neuroradiology Nov 1988, 9 (6) 1115-1122;
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