Lummel Nina, Wiesmann Martin, Brückmann Hartmut, Linn Jennifer
Department of Neuroradiology, University of Munich, Munich, Germany,
Clin Neuroradiol. 2010 Mar;20(1):38-47. doi: 10.1007/s00062-010-0026-5. Epub 2010 Feb 28.
The aim of this study was to determine the value of different magnetic resonance imaging (MRI) sequences for the diagnosis of intraventricular hemorrhages (IVHs).
The study included 22 consecutive patients with computed tomography (CT) proven IVH in which an MR examination had been performed. Proton-density-(PD-), T2-, fluid-attenuated inversion-recovery (FLAIR), T1- and T2*-weighted images were evaluated retrospectively by two neuroradiologists regarding presence and anatomical distribution of IVH, and cerebrospinal fluid (CSF) flow artifacts. CT was used as gold standard.
According to CT, IVH was located in the right/left lateral ventricles in 16/17 patients, in the third ventricle in seven and in the fourth ventricle in twelve cases. PD- and T2*-weighted images both showed a 100% sensitivity and specificity for the overall diagnosis of IVH, and a high sensitivity for the detection of IVH in all four ventricles. The sensitivity of T1-, T2- and FLAIR- weighted images for the overall presence of an IVH was 77%, 85%, and 93%, respectively, with specificities of 100%. CSF flow artifacts occurred predominantly in the third and fourth ventricles. While FLAIR- and T2-weighted sequences were especially prone to this phenomenon, T1-, T2*- and PD-weighted images showed a higher resistance to those artifacts.
This study demonstrates a high sensitivity of PD- and T2*-weighted images in the detection of IVH. On the contrary, T2-, T1- and FLAIR-weighted sequences were not suitable for a reliable detection of IVH.
本研究旨在确定不同磁共振成像（MRI）序列对诊断脑室内出血（IVH）的价值。
本研究纳入了22例经计算机断层扫描（CT）证实为IVH且已接受MR检查的连续患者。两名神经放射科医生对质子密度（PD）加权、T2加权、液体衰减反转恢复（FLAIR）加权、T1加权和T2*加权图像进行回顾性评估，观察IVH的存在情况、解剖分布以及脑脊液（CSF）流动伪影。CT被用作金标准。
根据CT结果，16/17例患者的IVH位于右侧/左侧侧脑室，7例位于第三脑室，12例位于第四脑室。PD加权和T2加权图像对IVH的总体诊断敏感性和特异性均为100%，对所有四个脑室内IVH的检测敏感性也很高。T1加权、T2加权和FLAIR加权图像对IVH总体存在情况的敏感性分别为77%、85%和93%，特异性均为100%。CSF流动伪影主要发生在第三和第四脑室。虽然FLAIR加权和T2加权序列特别容易出现这种现象，但T1加权、T2加权和PD加权图像对这些伪影的耐受性更高。
本研究表明PD加权和T2*加权图像在检测IVH方面具有较高的敏感性。相反，T2加权、T1加权和FLAIR加权序列不适合可靠地检测IVH。
