Hernalsteen D, Dignac A, Oppenheim C, Peeters A, Hermoye L, Duprez T, Cosnard G
Department of Neuroradiology, cliniques universitaires Saint-Luc, 1200 Brussels, Belgium.
J Neuroradiol. 2007 Mar;34(1):42-8. doi: 10.1016/j.neurad.2007.01.001.
We aimed to evaluate the diagnostic accuracy of MRI for detecting early intraventricular hemorrhage (IVH) (within 6 hours after hemorrhage and to describe the MR features that allow diagnosis. For this purpose, MR data of 22 patients with hyperacute intraparenchymal hemorrhage were independently rated as negative or positive for IVH by two observers, in a blind, retrospective study taking computed tomography (CT) as providing the correct diagnosis of IVH. Sensitivity, specificity, intra- and interobserver agreement were assessed. On FSE-FLAIR, EPI-GRE-T2* and DWI images, all cases of IVH were correctly rated (sensitivity of 100%). For b0 EPI images, obtained from diffusion-weighted echo planar sequences, one case of IVH was missed by one reader (sensitivity of 88%). For T1 images, one patient was incorrectly rated negative for IVH by the two readers (sensitivity of 90%). Three forms of IVH were described, including clotted hematoma, layered hemorrhage and red blood cell deposit. When CT images were obtained within a time span of less than 3 hours after MRI, volume was assessed. Volume of hemorrhage on CT correlated best with DWI images but was underestimated on EPI-GRE T2* images.
我们旨在评估MRI检测早期脑室内出血（IVH）（出血后6小时内）的诊断准确性，并描述有助于诊断的MR特征。为此，在一项以计算机断层扫描（CT）作为IVH正确诊断的盲法回顾性研究中，两名观察者对22例超急性脑实质内出血患者的MR数据独立评定为IVH阴性或阳性。评估了敏感性、特异性、观察者内和观察者间的一致性。在FSE-FLAIR、EPI-GRE-T2和DWI图像上，所有IVH病例均被正确评定（敏感性为100%）。对于从扩散加权回波平面序列获得的b0 EPI图像，一名读者漏诊了1例IVH（敏感性为88%）。对于T1图像，两名读者将1例患者错误评定为IVH阴性（敏感性为90%）。描述了三种IVH形式，包括凝血块、分层出血和红细胞沉积。当在MRI后不到三小时的时间内获得CT图像时，评估出血量。CT上的出血量与DWI图像相关性最好，但在EPI-GRE T2图像上被低估。
