Abstract
Gradient-echo (GE) MRI has been demonstrated to be the most sensitive current technique for detection of intracerebral haemosiderin, especially in the chronic stage of haemorrhage. Our purpose was to see whether GE MRI shows old haemorrhage indefinitely. We reviewed serial GE images of 105 adults with imaging features consistent with post-traumatic intracerebral haemorrhage, who had serial MRI at 1, 4–6, 12, and 24 months after trauma. Of 1235 scattered low-signal foci consistent with isolated intracerebral haemosiderin deposits on images at 4–6 months, 248 (20.1%) were not seen at 24-month assessment. Reviewing individual patients, we saw that in 71.8% of those with scattered haemosiderin deposits and 46.4% of those with haemosiderin surrounded by gliosis, the low-signal foci appeared less conspicuous with time. Even given certain limitations to the interpretation of these findings, it would appear that, even with the use of GE MRI, time affects the visibility of haemorrhagic intracerebral lesions. We therefore conclude that a time of 4–6 months to 1 year or slightly more should be recommended for most precise detection of haemosiderin deposits on MRI of head-injured patients, should this be thought desirable. Normal GE images may not exclude old haemorrhage.
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Acknowledgements
We thank Professor F. Angeleri, lately Director of the Neurological Clinic of the General Hospital and University of Ancona, Professor M. Signorino, Dr G. Cacchiò, Dr S. D’Acunto and their colleagues for their work on prospective study on TBI. We are especially grateful to Dr L. Regnicolo, and to M. Cola, C. Novelli and T. Tarabelli of the MRI Unit of the University of Ancona, who made the long-term imaging study possible. We also thank Dr Simone Salvolini of the University of Ancona, for his assistance with data collection.
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Messori, A., Polonara, G., Mabiglia, C. et al. Is haemosiderin visible indefinitely on gradient-echo MRI following traumatic intracerebral haemorrhage?. Neuroradiology 45, 881–886 (2003). https://doi.org/10.1007/s00234-003-1048-3
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DOI: https://doi.org/10.1007/s00234-003-1048-3