磁敏感加权成像及FLAIR序列在儿童创伤性颅内出血诊断中的价值

目的：探讨磁敏感加权成像（swI）及液体衰减反转恢复（FLAIR）序列在儿童创伤性颅内出血中的诊断价值。方法：36例颅脑外伤患儿,年龄3天～9岁,平均（2．6±2．6）岁。所有患者采用3．0TMR机进行T1.wT.T2wI、swI及FLAIR序列扫描。对比常规MRI序列（T1WI,T2WI）与swI和FLAIR序列三种检查方法在发现脑实质微出血（CMBs）、硬膜下或外出血、蛛网膜下腔出血（SAH）及脑室内出血的数量有关差异,并分析颅内各种出血的信号特点。结果：36例中常规MRI、SwI和FLAIR序列检出的脑实质微出血灶分别为80、197和65个,检出的硬膜下或外出血分别为45、45和44个部位,检出的SAH分别为7、10和13例,分别检出4、7和4例患儿存在脑室内出血。在检出脑实质微出血中,swI与常规MRI（X2=166．419,P=0．001）和FLAIR序列（X2=198．504,P=0．001）间差异有统计学意义（P〈0．05）。在检出SAH方面,FLAIR序列与常规MRI序列间差异有统计学意义（P=0．015）。颅内出血的信号特点较复杂,swI图像上颅内出血,尤其是硬膜下或外出血,可以表现为高信号或混杂信号。结论：swI较常规MRI和FLAIR序列能发现更多的微出血灶及脑室内出血,FLAIR序列在检出SAH方面具有独特的优势,综合应用MRI扫描序列对于儿童创伤性颅内出血的诊断及预后的判断有很高的价值。     

磁敏感加权成像在高血压脑微出血中应用价值的探讨

目的:探讨磁敏感加权成像在高血压脑微出血中的应用价值.方法:采用1.5T MR扫描仪,对48例高血压脑微出血患者分别进行常规和SWI序列扫描,比较各序列对于脑微出血灶的数量、部位、分布的显示情况.结果:T2WI序列检出低信号灶169个,T2FLAIR序列检出低信号灶273个,SWI序列检出低信号灶1335个,各序列显示...     

磁敏感加权成像在脑内微出血影像诊断中的价值

目的：探讨磁敏感加权成像（SWI）在脑微出血（CMBs）影像诊断中的价值。方法：对232例拟诊脑血管病患者行常规MR头颅平扫T2WI、T2FLAIR、T1WI、DWI序列及SWI序列,对常规序列显示的CMBs数目、敏感性与SWI序列比较并进行统计学处理。结果：28例有脑内微出血,SWI序列共检出CMBs 186个,T2WI序列共检出CMBs 38个,CMBs病灶检出敏感性为20.4%;T1WI序列共检出CMBs 21个,CMBs病灶检出敏感性为11.3%。T2FLAIR共检出CMBs 41个,CMBs病灶检出敏感性为22%,DWI序列共检出CMBs 24个,CMBs病灶检出敏感性为12.9%,多序列CMBs检出数目比较,差异有统计学意义（P〈0.05）;SWI序列与T1WI、T2WI、T2FLAIR、DWI序列CMBs检出敏感性比较,差异具有统计学意义（P〈0.05）;28例中,22例有高血压病史,同时合并出血性卒中患者14例,缺血性卒中患者8例,混合性卒中患者6例。结论：SWI序列对CMBs的检出敏感性高于常规序列,CMBs病灶的检出可以反映脑内微血管病变程度,对脑卒中的治疗及预后判断具有较为重要的临床应用价值。     

出血性脑梗死的MRI特征性表现及其分型

目的：探讨出血性脑梗死（HI）的MRI特征性表现和分型。方法：采用1．5T MR,对50例HI行常规序列扫描（T1WI、T2WI、FLAIR）。必要时行MRA（42例）、增强扫描（4例）及T2＊WI（27例）。结果：根据梗死、出血的形态、部位进行MRI分型。Ⅰ型：脑叶HI：22例（44．0％）脑回状、斑片状出血位于皮层和／或皮层下白质。Ⅱ型：脑深部（基底节及丘脑）HI：17例（34．0％）;Ⅲ型：小脑HI：14例（28．0％）;斑片状、线状出血位于梗塞区内、边缘。混合型（Ⅰ型＋Ⅱ型）：3例（6％）。T2＊WI呈低信号。结论：HI的MRI表现有一定特征性,与脑梗死部位、面积有密切关系。新的MRI分型有助于对HI发生机制的理解,从而指导临床治疗。T2＊WI有助于HI的检出。     

多序列MRI评估脑外伤微出血及弥漫性轴索损伤

目的探讨MR常规序列(T1WI、T2WI、T2FLAIR)、扩散加权成像(diffusion-weighted imaging, DWI)及磁敏感序列(susceptibility weighted imaging, SWI)在脑外伤微出血及弥漫性轴索损伤(DAI)中的应用价值。方法对48例脑外伤患者,应用3.0T MR行常规MRI、DWI及SWI序列成像,比较各序列微出血灶及DAI病灶的检出率差异,并分析病灶在这些序列上的位置分布特点、信号特征。结果联合多种序列共检出547个剪切灶及微出血灶。T1WI检出205个病灶,T2WI检出358个病灶,T2FLAIR检出432个病灶,DWI检出396个病灶,SWI检出471个病灶,SWI病灶检出率高于常规T1WI(χ^2=273.94)、T2WI(χ^2=63.59)、T2FLAIR(χ^2=9.648)、DWI序列(χ^2=31.27),其检出率差异具有统计学意义(P<0.01)。DWI检出的大部分(80%)非出血性剪切灶表现为扩散受限、ADC值减低。SWI图像上微出血灶表现为条状、点状及类圆形低信号,病灶主要分布在皮髓质交界区及深部脑白质区域,位于皮髓交界区病灶排列呈甩鞭样或串珠状,具有特征性。结论 SWI序列对脑外伤微出血的敏感性高,多种序列联合应用对脑外伤微出血和DAI各期的诊断有重要的临床价值。     

磁共振膝关节软骨形态表现的组织学相关性研究

目的：对照膝关节软骨磁共振和组织学表现，分析不同磁共振序列反映关节软骨厚度和组织学分层的能力与限度。材料和方法：分别对12例新鲜离体人膝关节标本采用以下序列行软骨磁共振成像：①SE T1加权序列；②FSE T2加权序列；③STIR序列；④3D—FS—SPGR序列；⑤FS—PD序列；⑥T2^＊加权GRE序列。选取各序列图像髁间凹中央层面髌软骨最厚区域为感兴趣区，测定软骨厚度及各分层大致厚度。成像后在标本相应部位取材以获得深及软骨下骨的软骨组织并行甲苯胺蓝染色。光镜下测定软骨厚度各组织层次厚度。对MR和组织学测定的参数进行对照分析。结果：①不同MR序列所显示的髌软骨厚度差异明显（F=36．470，P=0．041）；②FS—PD、FS—SPGR和T2^＊GRE所测软骨厚度与组织学测量值之间无显著差异（P=1．432，0．097，0．064），以FS—PD序列显示的髌软骨厚度值的组织学相关性最高（r=0．787）；③MR与组织学检查所显示的关节软骨层次之间具有显著性差异，两者的软骨层次厚度之间存在显著性差异（χ^2=13．12，P=0．012）；两者之间无相关性（P值均小于0．05）。结论：MR成像技术能精确反映关节软骨整体厚度变化；但MR软骨分层表现受多种因素共同影响，与组织学层次之间无相关性。     

不同TE T_2*WI序列对各期脑出血检出率的比较研究

目的：比较不同TE T2＊WI序列对各期脑出血的检出率,探讨颅内出血在不同时期的最佳检出方法。方法：以ESWAN序列作为金标准,对已确诊脑出血的18例52个病灶进行不同TE（15、30、45ms）的SPGR T2＊WI检查,并对结果进行统计学分析。结果：T2＊WI（15、30、45ms）与ESWAN序列对急性期和亚急性Ⅰ期出血灶的检出率基本相同,而对亚急性期Ⅱ期、慢性期两者检出率：TE=15ms T2＊WI对各期出血灶的总检出率为76．92％,误诊率为0％;TE-30ms T2＊WI总检出率为88．46％,误诊率为0％;TE=45ms T2＊WI检出率为100％,但误诊率为9．6％。与TE=45ms时比较,TE=30ms T2＊WI具有扫描时间较短、图像分辨率高的优点。结论：T2＊WI（TE=30ms）序列对于脑出血的快速检出具有一定优势。     

磁敏感加权成像及增强T1WI FLAIR序列在脑-三叉神经血管瘤病MR诊断中的应用探讨

目的：探讨磁敏感加权成像（susceptibility weighted imaging,SWI）及增强T1WI FLAIR（cT1F）序列MR图像在脑-三叉神经血管瘤病诊断中的价值.材料和方法：回顾性观察分析海军总医院15例脑-三叉神经血管瘤病的MRI资料,全部病例均接受了MR平扫（T1WI,T2WI）、cT1F、SWI扫描,重点观察各序列对经髓静脉扩大、脑室周围静脉扩大、脉络丛扩大、柔脑膜异常、皮质脑回异常、脑灰白质交界处异常的显示,评价其显示能力.结果：对于经髓静脉扩大、脑室周围静脉扩大、皮质脑回异常、脑灰白质交界处异常的显示方面SWI优于cT1F扫描和常规MR扫描,而对于脉络丛扩大及柔脑膜异常的显示,cT1F扫描要优于SWI序列.结论：SWI和cT1F扫描可以为脑-三叉神经血管瘤病诊断提供重要的信息,它们与常规MR联合应用更有利于准确地对脑-三叉神经血管瘤病的进行诊断.     

磁敏感成像在脑微出血诊断中的应用价值

目的：探讨磁敏感成像（SWI）对脑微出血的诊断价值,以及对临床利用溶栓药物治疗脑梗死可能出现的脑出血等潜在危险的预见性。方法：66例原发性高血压患者,通过常规T1WI及T2WI检查,根据是否存在脑梗死或腔隙脑梗死分为存在基础病变的高危组（44例）和无基础病变的对照组（22例）。分析两组患者SWI序列显示脑微出血灶的阳性率。结果：所有受检者SWI显示满意。统计分析两组病例在SWI序列中脑微出血灶的个数以及病灶出现的部位。22例对照组中,SWI阳性者为3例。44例高危组中,阳性者为21例。24例阳性患者中,微出血灶出现在基底节区15例,出现在枕、顶、颞、额叶皮层共9例。结论：SWI在检出脑微出血灶方面有明显的优势。对于存在脑梗死等基础病变的高血压患者,SWI显示脑微出血灶的阳性率明显高于单纯高血压患者,可为临床应用溶栓药治疗脑梗死时提供参考。     

联合SWI与DWI在急性脑弥漫性轴索损伤中的应用价值

目的：评价联合磁敏感成像（SWI）与扩散加权成像（DWI）在急性期脑弥漫性轴索损伤中的应用价值。方法：32例脑弥漫性轴索损伤急性期患者,所有患者行常规MRI序列、DWI及SWI序列全脑扫描。结果：共检出病灶313个,T1WI 78个,T2WI 207个,FLAIR 292个,DWI 286个,SWI 297个。SWI显示245个病灶内分布斑片状、点状出血灶,其它序列共显示43个内分布出血灶。SWI、DWI病灶检出率高于常规T2WI（χ2=82.465,χ2=59.584;P〈0.01）,SWI、FLAIR及DWI病灶检出率无明显差异（χ2=3.052;P〉0.05）。结论：联合SWI与DWI有利于提高急性脑弥漫性轴索损伤的检出率,有助于准确评价病变的严重程度,SWI与DWI应作为急性脑弥漫性轴索损伤的常规扫描序列组合。     

Diffuse axonal injury associated with chronic traumatic brain injury: evidence from T2*-weighted gradient-echo imaging at 3 T

BACKGROUND AND PURPOSE: Diffuse axonal injury is frequently accompanied by tissue tear hemorrhages. We examined whether high field strength T2*-weighted gradient-echo imaging performed during the chronic stage of traumatic brain injury may have advantages in the evaluation of diffuse axonal injury as compared with T1- and T2-weighted MR imaging. METHODS: Prospective MR imaging of 66 patients (age range, 17-57 years) was performed using a 3-T system 3 to 292 months (median, 23.5 months) after traumatic brain injury. T1-, T2-, T2*-hypointense and T2-hyperintense foci of 1- to 15-mm diameter were registered in 10 brain regions by two readers separately. Foci that appeared hypointense both on the T1- and T2- and/or on the T2*-weighted images were defined as traumatic microbleeds. RESULTS: For 46 (69.7%) of the patients, T2*-weighted gradient-echo imaging revealed traumatic microbleeds. Hyperintense foci were observed on the T2-weighted images of only 15 (22.7%) patients. T2*-weighted imaging showed significantly more traumatic microbleeds (P =.000) than did T1- and T2-weighted imaging. Interobserver agreement was strong (kappa = 0.79, tau = 0.749, P =.000). For 14 (21.2%) of the patients, T2*-weighted gradient-echo imaging revealed traumatic microbleeds in the corpus callosum, whereas for only two (3%), hyperintense callosal lesions were seen on the T2-weighted images. Although a significant correlation existed between the total amount and callosal appearance of traumatic microbleeds and Glasgow Coma Scale scores (P =.000), no correlation existed with extended Glasgow Outcome Scale scores. CONCLUSION: T2*-weighted gradient-echo imaging at high field strength is a useful tool for the evaluation of diffuse axonal injury during the chronic stage of traumatic brain injury. Diffuse axonal injury-related brain lesions are mainly hemorrhagic. The relevance of diffuse axonal injury for long-term clinical outcome is uncertain.     

磁共振相位成像和R2~*定量评估阿尔茨海默病脑内铁质沉积

目的：研究显示阿尔茨海默病（AD）患者脑内存在铁质过度沉积,并与B淀粉样变以及氧化应激直接相关。通过磁共振相位值和R2^＊值的测量可以定量评估铁质在脑内的聚积程度。本文的目的在于比较上述两种方法在评估阿尔茨海默脑病患者和年龄匹配的正常老年纽间的差异。方法：阿尔茨海默病患者26例,正常健康老年人24例,前组均经临床神经科医师根据美国国立神经及交流疾病和脑卒中研究院、Alzheimer病及相关疾病协会（NINCDS-ADRDA）关于可能AD拟诊标准作出诊断。采用GESigna HD 1．5T磁共振扫描仪,8通道头线圈,检查序列包括冠状面三维高分辨率梯度回波和快速多回波梯度序列,经后处理获得校正后的相位图和R2。图,在上述两幅功能图上测量相同层面的双侧壳核、苍白球以及双侧海马的头部和体部的参数值。结果：阿尔茨海默脑病组基底节和海马区域的相位值较对照组有明显下降（P〈0．05）。R2^＊值在苍白球部位显示有明显升高（P〈0．05）。右侧海马头部的相位值与MMSE评分具有中等程度相关性（r=0．603,P=0．000）,而与阿尔茨海默病的病程呈负相关（r=-0．677,P=0．013）。以-0．0972作为诊断的最优临界值,诊断阿尔茨海默病的敏感度和特异度分别为95．8％和80．8％。结论：相位成像对于鉴别正常老年人和阿尔茨海默脑病更具敏感度和有效度。研究海马区铁质过多积聚有助于更好地认识阿尔茨海默脑病的病理发展过程和神经精神功能损害的机制。     

卒中患者脑微出血的MRI特点及其临床意义

目的 探讨卒中患者脑微出血（CMBs）的MRI特点及其临床意义，并比较MRI不同扫描序列检出CMBs的能力。方法 卒中患者60例，分为脑缺血组（34例）和脑出血组（26例），以同期查体的60岁以上健康老年人为对照组（30例）。采用常规MRI（包括SE T1WI和FSE T2WI）、扩散加权成像（DWI）、梯度回波T2加权成像（GRE-T2WI）和平面回波成像（EPI）检查，分别统计各组CMBs、腔隙性梗死、脑白质稀疏情况，同时记录卒中患者的高血压、糖尿病、卒中病史，比较不同扫描序列检出CMBs的差异。结果 CMBs在缺血组、出血组和对照组的发生率分别为29．4％，61．5％和6．7％。CMBs最常见于基底节／丘脑区。CMBs与高血压、卒中病史相关（P〈0．01），而与糖尿病无关（P〉0．05）。CMBs的数目与腔隙性脑梗死的数目和脑白质的改变程度成正相关（P〈0．01）。常规MRI和DWI均不能显示CMBs，EPI与GRE-T2WI检出CMBs的差异无统计学意义（P〉0．05）。结论 脑卒中患者多发性CMBs的存在提示微血管病变的严重程度和出血倾向，对于临床治疗决策具有重要的指导意义。GRE-T2WI是检测CMBs的首选方法，EPI可作为GRE-T2WI的补充手段。     

ESWAN序列在脑出血诊断中的应用价值

目的探讨磁敏感加权成像(ESWAN)在脑出血诊断中应用价值。方法对41例临床确诊脑出血患者行常规MR序列(T1WI、T2WI、FLAIR、DWI)、T2*GRE、ESWAN检查,对ESWAN图像进行后处理,获得ESWAN幅度图、相位图及最小密度投影(MinIP)图。对常规序列、T2*GRE、ESWAN各序列检出的出血灶数量、大小进行评估及统计分析。结果常规序列、T2*GRE、ESWAN对总出血灶及脑微出血灶(CMB)的检出率比较为:ESWAN>T2*GRE>常规序列;ESWAN序列对于微出血灶的检出率明显高于T2*GRE及常规序列。结论相对于常规序列及T2*GRE,ESWAN能更准确的检测出血灶数量,对梗死后微出血独具诊断优势。     

Brain microhemorrhages detected on T2*-weighted gradient-echo MR images

BACKGROUND AND PURPOSE: Multifocal microhemorrhages have been reported to be commonly found in the brain of patients with systemic hypertension and spontaneous brain hemorrhage. The factors associated with these lesions detected on T2*-weighted gradient-echo images were examined to determine whether these lesions serve to indicate different types of microangiopathy and to predict a patient's risk for symptomatic hemorrhage. METHODS: The study population consisted of 2164 patients who underwent 2416 consecutive brain MR imaging studies performed during 3 years. The patients with intracerebral hemorrhages due to vascular malformations, neoplasms, trauma, or intracranial surgery and those with incomplete medical records were excluded; 2019 cases were analyzed. RESULTS: The overall incidence of microhemorrhages was 9.8%, predominantly in the lentiform nucleus (n = 96), thalamus (n = 88), and cortical-subcortical region (n = 93). Presence of microhemorrhages had the highest significant correlation with history of hemorrhagic stroke (P <.0001); advancing age, hypertension, and prominent white matter hyperintensity on T2-weighted images had the next highest significant correlation. Cortical-subcortical microhemorrhages were more frequently observed in patients who had previous lobar hemorrhagic stroke (P <.005). Among 139 patients with microhemorrhages who could be clinically followed up for more than 1 month, four (2.9%) had new hemorrhagic stroke. CONCLUSION: The presence of microhemorrhages may be not only a direct marker of bleeding-prone small-vessel diseases but also an indicator of different types of microangiopathy and a predictor of further hemorrhagic stroke.     

Meckel腔病变的常规MRI和扩散加权成像表现

目的：探讨各种Meckel腔病变的常规MRI和扩散加权成像（DWI）特点.方法：回顾性分析30例Meckel腔病变（31处病变）的MRI表现,且与临床资料、病理诊断及手术结果进行对照分析.结果：31处Meckel腔病变中以肿瘤（n=28）最常见.病变T1WI呈等信号（n=18）、不均匀信号（n=11）、稍低信号（n=1）或稍高信号（n=1）;T2WI呈稍高信号（n=8）、等信号（n=7）、高信号（n=6）及不均匀信号（n=10）;所有病变增强扫描均显著强化.30例病变DWI上呈高信号,且31例呈不同的ADC值,平均ADC值为（1.09±0.22）×10-3mm2/s,最小值为（0.59±0.11）×10-3mm2/s（小细胞型神经内分泌癌）,最大值为（2.09±0.41）×10-3mm2/s（软骨肉瘤）.结论：常规MRI与DWI和ADC值相结合,对诊断各种Meckel腔病变具有重要价值.     

软骨肉瘤的影像诊断与鉴别诊断

目的:探讨软骨肉瘤的影像学表现,提高对本病诊断的准确性。方法:回顾性分析25例经手术病理证实的软骨肉瘤的X线、CT和MRI资料。结果:25例软骨肉瘤中原发23例,其中普通型20例,去分化型、黏液型及透明细胞型各1例;继发2例。X线及CT表现:原发的23例中溶骨性骨破坏5例,混合性骨破坏18例,形成软组织肿块20例,其中表现为低密度19例,等密度1例。20例普通型及1例黏液型见散在钙化。MRI表现:普通型软骨肉瘤T1WI呈等或稍低信号,T2WI呈等或稍高信号;黏液型T1WI呈等、低混杂信号,T2WI呈稍高、低的混杂信号,钙化T2WI呈低信号;透明细胞型病例T1WI及T2WI呈近乎等信号;去分化型T1WI呈等低混杂信号,T2WI呈不均匀高信号。6例普通型及1例继发型出现环形、间隔样中等-明显强化,黏液型及去分化型呈不均匀中等-明显强化。结论:普通X线及CT是软骨肉瘤影像诊断及鉴别诊断的主要手段,MRI显示软骨信号为重要提示。MRI显示病变范围更为清楚、准确,为临床治疗提供可靠依据。     

Frequency of asymptomatic microbleeds on T2*-weighted MR images of patients with recurrent stroke: association with combination of stroke subtypes and leukoaraiosis

BACKGROUND AND PURPOSE: Asymptomatic microbleeds shown by T2*-weighted MR imaging are associated with small-artery diseases, especially with intracerebral hemorrhage. Few studies have focused on the prevalence of microbleeds in patients with recurrent stroke. We investigated frequency of microbleeds in patients with recurrent stroke and association of presence of microbleeds with a combination of stroke subtypes and severity of leukoaraiosis. METHODS: The study population consisted of 102 patients with primary stroke and 54 patients with recurrent stroke. Microbleeds were counted and classified by using T2*-weighted MR imaging with a 1.0-T system. RESULTS: Patients with recurrent stroke showed a significantly higher prevalence of microbleeds (68.5%) than did patients with primary stroke (28.4%) (P <.0001). Among patients with recurrent stroke, the highest frequency of microbleeds occurred in those with intracerebral hemorrhage alone (92.3%), with the next highest frequency occurring in those with a combination of intracerebral hemorrhage and ischemic stroke (76.5%) and then those with ischemic stroke alone (50.0%) (P <.05). Leukoaraiosis was more severe in patients with recurrent stroke than in patients with primary stroke, and correlations between grade of microbleeds and severity of leukoaraiosis were found in patients with primary stroke (r = 0.367, P <.001) and in patients with recurrent stroke (r = 0.553, P <.0001). Logistic regression analysis identified recurrent stroke (odds ratio, 4.487; 95% confidence interval, 1.989-10.120) and leukoaraiosis (odds ratio, 5.079; 95% confidence interval, 2.125-12.143) as being significantly and independently associated with microbleeds. CONCLUSION: Asymptomatic microbleeds are observed to occur frequently in patients with recurrent stroke, either hemorrhagic or ischemic stroke, and are closely associated with the severity of leukoaraiosis.     

3.0T磁敏感加权成像在脊髓出血性病变中的应用价值

目的:探讨磁敏感加权成像在脊髓出血性病变中的应用价值。方法:32例脊髓出血性病变患者(病变组)和16例健康志愿者(对照组)行3.0T磁敏感加权成像(SWI)、二维扰相梯度回波T2*加权(2D-MERGE T2*WI)、FSE T1WI及FSE T2WI扫描。32例病例均经临床随访及病理证实,包括脊髓挫裂伤20例、脊髓动静脉畸形6例、脊髓海绵状血管瘤2例、脊髓星形细胞瘤伴出血4例。比较分析SWI及2D-MERGE T2*WI、常规FSE T2WI对脊髓出血性病变检出的敏感度和特异度。结果:20例脊髓挫裂伤患者常规FSE T2WI均显示水肿征象,其中4例脊髓挫裂伤在SWI、2D-MERGET2*WI、常规FSE T1WI及FSE T2WI均未见出血征象,8例脊髓挫裂伤仅在SWI显示出血征象,另外8例脊髓挫裂伤、6例脊髓动静脉畸形、2例脊髓海绵状血管瘤和4例脊髓星形细胞瘤伴出血在SWI显示低信号出血征象较2D-MERGET2*WI及常规FSE T2WI更敏感。结论:3.0T磁敏感加权成像检出脊髓出血性病变比常规MRI更敏感,可作为脊髓出血性病变MRI检查重要的补充序列。     

Assessment of hemorrhage in pituitary macroadenoma by T2*-weighted gradient-echo MR imaging

BACKGROUND AND PURPOSE: Intratumoral hemorrhage occurs frequently in pituitary macroadenoma and manifests as pituitary apoplexy and recent or old silent hemorrhage. T2*-weighted gradient-echo (GE) MR imaging is the most sensitive sequence for the detection of acute and old intracranial hemorrhage. T2*-weighted GE MR imaging was used to investigate intratumoral hemorrhage in pituitary macroadenomas. MATERIALS AND METHODS: Twenty-five consecutive patients who underwent total or subtotal resection of pituitary macroadenoma with heights from 17 to 53 mm, including 1 patient with classic pituitary apoplexy, underwent MR imaging before surgery, including T2*-weighted GE MR imaging. For histologic assessment of the hemorrhage in whole surgical specimens, we used hematoxylin-eosin staining. RESULTS: T2*-weighted GE MR imaging detected various types of dark lesions, such as "rim," "mass," "spot," and "diffuse" and combinations, indicating clinical and subclinical intratumoral hemorrhage in 12 of the 25 patients. The presence of intratumoral dark lesions on T2*-weighted GE MR imaging correlated significantly with the hemorrhagic findings on T1- and T2-weighted MR imaging (P < .02 and <.01, respectively), and the surgical and histologic hemorrhagic findings (P < .001 and <.001, respectively). CONCLUSION: T2*-weighted GE MR imaging could detect intratumoral hemorrhage in pituitary adenomas as various dark appearances. Therefore, this technique might be useful for the assessment of recent and old intratumoral hemorrhagic events in patients with pituitary macroadenomas.