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KMID : 1144720200240030154
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Investigative Magnetic Resonance Imaging
2020 Volume.24 No. 3 p.154 ~ p.161
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Leak Sign on Dynamic-Susceptibility- Contrast Magnetic Resonance Imaging in Acute Intracerebral Hemorrhage
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Park Ji-Kang
Hong Dae-Young
Jin Sun-Tak
Lee Dong-Woo
Pyun Hae-Wook
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Abstract
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Purpose: A CT angiography spot sign (CTA-spot) is a significant predictor of the early expansion of an intracerebral hemorrhage (ICH-Ex). Dynamic-susceptibility-contrast magnetic resonance imaging (DSC-MRI) can track the real-time leaking of contrast agents. It may be able to indicate active bleeding, like a CTA-spot.
Materials and Methods: From September 2014 to February 2017, we did noncontrast CT, CTA, and DSC-MRI examinations of seven patients with acute ICH. We investigated the time from symptom onset to the first contrast-enhanced imaging.
We evaluated the time course of the contrast leak within the ICH at the source image of the DSC-MRI and the volume change of ICH between non-contrast CT and DSCMRI. We compared the number of slices showing CTA-spots and DSC-MRI leaks.
Results: The CTA-spot and DSC-MRI leak-sign were present in four patients, and two patients among those showed ICH-Ex. The time from the symptom onset to CTA or DSC-MRI was shorter for those with a DSC-MRI leak or CTA-spot than for three patients without either (70-130 minutes vs. 135-270 minutes). The leak-sign began earlier, lasted longer, and spread to more slices in the patients with ICH-Ex than in those without ICH-Ex. The number of slices of the DSC-MRI leak and the number of the CTA-spot were well correlated.
Conclusion: DSC-MRI can demonstrate the leakage of GBCA within hyperacute ICH, showing the good contrast between hematoma and contrast. The DSC-MRI leakage sign could be related to the hematoma expansion in patients with ICH.
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KEYWORD
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Intracerebral hemorrhage, CTA-spot sign, DSC-MRI
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