Magazine article Clinical Psychiatry News

MRI Equals CT in Confirming Acute Intracerebral Hemorrhage

Magazine article Clinical Psychiatry News

MRI Equals CT in Confirming Acute Intracerebral Hemorrhage

Article excerpt

Magnetic resonance imaging is superior to CT for detection of chronic brain hemorrhage and is its equal in confirming suspected acute intracerebral hemorrhage, judging from the findings of a prospective, multicenter study.

Many stroke centers currently obtain both MRI and CT in initial evaluations of suspected brain hemorrhage, a practice that is costly in both time and money. Given the new findings, MRI "may be acceptable as the sole imaging technique for acute stroke at centers with expertise," reported Chelsea S. Kidwell, M.D., of the UCLA Stroke Center, and associates.

The findings of the Hemorrhage and Early MRI Evaluation (HEME) study also suggest that gradient recalled echo (GRE) MRI--in addition to detecting hyperacute and chronic hemorrhage--may be able to detect regions of hemorrhagic transformation of an acute ischemic stroke that are not evident on CT (JAMA 2004;292:1823-30).

The study was performed between 2000 and 2003 at two stroke centers. Patients in the study had a mean age of 75 years. Patients presenting with focal stroke symptoms within 6 hours of onset underwent brain GRE MRI followed by noncontrast CT. Scans were read by four blinded readers.

The findings complement another recently published study performed by the German Stroke Competence Network, which suggested that MRI is as accurate as CT for the detection of hyperacute hemorrhage (Stroke 2004;35:502-6).

In fact, when preliminary results of this other study became available, the HEME investigators performed an interim analysis of their own data and found that MRI was detecting acute hemorrhages not seen on CT. …

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