Adeli Amir, Behrouz Réza
Division of Cerebrovascular Diseases, Department of Neurology, Ohio State University College of Medicine, Columbus, OH, USA.
Neurohospitalist. 2015 Apr;5(2):59-62. doi: 10.1177/1941874414561030.
Despite the increased use and availability of magnetic resonance imaging (MRI), its role in hypertensive intracerebral hemorrhage (ICH) remains uncertain. In this retrospective study, we assessed the utility of MRI in diagnosis and management of patients with hypertensive ICH.
We retrospectively reviewed the charts of patients with ICH presenting to our hospital over an 18-month period. We included patients who presented with hypertensive ICH in typical locations and excluded lobar hemorrhages. We further isolated cases that had undergone MRI. Collected data included mean age, gender, location of hematoma, neuroradiologist's interpretative report of the MRI, and management steps taken in response to the results of the MRI. Logistic regression was used to determine whether the overall yield of MRI in these patients was significant.
We found 222 patients with ICH in our database. Forty-eight patients met our inclusion criteria, of which 24 had brain MRI done as a part of their hospital workup. Brain MRI obtained in 2 (8%) of the 24 patients revealed abnormalities that led to a change in management. The diagnostic yield of MRI and the management decisions that followed were both insignificant.
The diagnostic yield of brain MRI in patients with nonlobar hypertensive ICH is low and does not result in significant changes in management.
尽管磁共振成像（MRI）的使用越来越多且可及性提高，但其在高血压性脑出血（ICH）中的作用仍不明确。在这项回顾性研究中，我们评估了MRI在高血压性ICH患者诊断和管理中的效用。
我们回顾性分析了18个月期间我院收治的ICH患者病历。纳入典型部位出现高血压性ICH的患者，排除脑叶出血患者。我们进一步筛选出接受过MRI检查的病例。收集的数据包括平均年龄、性别、血肿位置、神经放射科医生对MRI的解读报告以及根据MRI结果采取的管理措施。采用逻辑回归分析来确定MRI在这些患者中的总体诊断价值是否显著。
我们的数据库中有222例ICH患者。48例符合纳入标准，其中24例在住院检查时进行了脑部MRI检查。24例患者中有2例（8%）的脑部MRI显示异常，从而导致了管理措施的改变。MRI的诊断价值及后续的管理决策均不显著。
非脑叶性高血压性ICH患者脑部MRI的诊断价值较低，且不会导致管理措施的显著改变。
