Chang Shixin, Zhang Jingwei, Liu Tian, Tsiouris Apostolos John, Shou Jian, Nguyen Thanh, Leifer Dana, Wang Yi, Kovanlikaya Ilhami
Department of Radiology, Yueyang Hospital of Integrated Traditional Chinese & Western Medicine, Shanghai, China.
Department of Radiology, Weill Cornell Medical College, New York, New York, USA.
J Magn Reson Imaging. 2016 Aug;44(2):420-5. doi: 10.1002/jmri.25143. Epub 2015 Dec 31.
To investigate the magnetic susceptibility of intracerebral hemorrhages (ICH) at various stages by applying quantitative susceptibility mapping (QSM).
Blood susceptibility was measured serially using QSM after venous blood withdrawal from healthy subjects. Forty-two patients who provided written consent were recruited in this Institutional Review Board-approved study. Gradient echo magnetic resonance imaging (MRI) data of the 42 patients (17 females; 64 ± 12 years) with ICH were processed with QSM. The susceptibilities of various blood products within hematomas were measured on QSM.
Blood susceptibility continually increased and reached a plateau 96 hours after venous blood withdrawal. Hematomas at all stages were consistently hyperintense on QSM. Susceptibility was 0.57 ± 0.48, 1.30 ± 0.33, 1.14 ± 0.46, 0.40 ± 0.13, and 0.71 ± 0.31 ppm for hyperacute, acute, early subacute, late subacute, and chronic stages of hematomas, respectively. The susceptibility decrease from early subacute (1.14 ppm) to late subacute (0.4 ppm) was significant (P < 0.01).
QSM reveals positive susceptibility in hyperacute hematomas, indicating that even at their hyperacute stage, deoxyhemoglobin may exist throughout the hematoma volume, not just at its rim, as seen on conventional T2* imaging. QSM also reveals a reduction of susceptibility from early subacute to late subacute ICH, suggesting that methemoglobin concentration decreases at the late subacute stage. J. Magn. Reson. Imaging 2016;44:420-425.
通过应用定量磁化率图谱（QSM）研究脑内出血（ICH）不同阶段的磁化率。
从健康受试者静脉采血后，使用QSM连续测量血液磁化率。在这项经机构审查委员会批准的研究中，招募了42名提供书面同意的患者。对42例ICH患者（17例女性；64±12岁）的梯度回波磁共振成像（MRI）数据进行QSM处理。在QSM上测量血肿内各种血液成分的磁化率。
血液磁化率持续增加，在静脉采血后96小时达到平台期。所有阶段的血肿在QSM上均持续呈高信号。超急性期、急性期、早期亚急性期、晚期亚急性期和慢性期血肿的磁化率分别为0.57±0.48、1.30±0.33、1.14±0.46、0.40±0.13和0.71±0.31ppm。从早期亚急性期（1.14ppm）到晚期亚急性期（0.4ppm）磁化率的降低具有显著性（P<0.01）。
QSM显示超急性血肿具有正磁化率，这表明即使在超急性阶段，脱氧血红蛋白可能存在于整个血肿体积内，而不仅仅像传统T2*成像所见那样仅存在于血肿边缘。QSM还显示从早期亚急性期到晚期亚急性期ICH的磁化率降低，提示晚期亚急性期高铁血红蛋白浓度降低。《磁共振成像杂志》2016年；44：420 - 425。
