Detecting subarachnoid hemorrhage: Comparison of combined FLAIR/SWI versus CT

Verma, Rajeev Kumar; Kottke, Raimund; Andereggen, Lukas; Weisstanner, Christian; Zubler, Christoph; Gralla, Jan; Kiefer, Claus; Slotboom, Johannes; Wiest, Roland; Schroth, Gerhard; Ozdoba, Christoph; El-Koussy, Marwan (2013). Detecting subarachnoid hemorrhage: Comparison of combined FLAIR/SWI versus CT. European journal of radiology, 82(9), pp. 1539-1545. Stuttgart: Elsevier 10.1016/j.ejrad.2013.03.021

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OBJECTIVES: Aim of this study was to compare the utility of susceptibility weighted imaging (SWI) with the established diagnostic techniques CT and fluid attenuated inversion recovery (FLAIR) in their detecting capacity of subarachnoid hemorrhage (SAH), and further to compare the combined SWI/FLAIR MRI data with CT to evaluate whether MRI is more accurate than CT. METHODS: Twenty-five patients with acute SAH underwent CT and MRI within 6 days after symptom onset. Underlying pathology for SAH was head trauma (n=9), ruptured aneurysm (n=6), ruptured arteriovenous malformation (n=2), and spontaneous bleeding (n=8). SWI, FLAIR, and CT data were analyzed. The anatomical distribution of SAH was subdivided into 8 subarachnoid regions with three peripheral cisterns (frontal-parietal, temporal-occipital, sylvian), two central cisterns and spaces (interhemispheric, intraventricular), and the perimesencephalic, posterior fossa, superior cerebellar cisterns. RESULTS: SAH was detected in a total of 146 subarachnoid regions. CT identified 110 (75.3%), FLAIR 127 (87%), and SWI 129 (88.4%) involved regions. Combined FLAIR and SWI identified all 146 detectable regions (100%). FLAIR was sensitive for frontal-parietal, temporal-occipital and Sylvian cistern SAH, while SWI was particularly sensitive for interhemispheric and intraventricular hemorrhage. CONCLUSIONS: By combining SWI and FLAIR, MRI yields a distinctly higher detection rate for SAH than CT alone, particularly due to their complementary detection characteristics in different anatomical regions. Detection strength of SWI is high in central areas, whereas FLAIR shows a better detection rate in peripheral areas.

Item Type:	Journal Article (Original Article)
Division/Institute:	04 Faculty of Medicine > Department of Head Organs and Neurology (DKNS) > Clinic of Neurosurgery 04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology
UniBE Contributor:	Verma, Rajeev Kumar, Kottke, Raimund, Andereggen, Lukas, Weisstanner, Christian, Zubler, Christoph, Gralla, Jan, Kiefer, Claus, Slotboom, Johannes, Wiest, Roland Gerhard Rudi, Schroth, Gerhard, Ozdoba, Christoph, El-Koussy, Marwan
Subjects:	600 Technology > 610 Medicine & health
ISSN:	0720-048X
Publisher:	Elsevier
Language:	English
Submitter:	Factscience Import
Date Deposited:	04 Oct 2013 14:39
Last Modified:	02 Mar 2023 23:21
Publisher DOI:	10.1016/j.ejrad.2013.03.021
PubMed ID:	23632159
URI:	https://boris.unibe.ch/id/eprint/15727 (FactScience: 223156)