MAGNETIC-RESONANCE IMAGING-DOCUMENTED EXTRAVASATION AS AN INDICATOR OF ACUTE HYPERTENSIVE INTRACEREBRAL HEMORRHAGE

Object. The aim of this study was to determine the usefulness of magne tic resonance (MR) imaging-documented extravasation as an indicator of continued hemorrhage in patients with acute hypertensive intracerebra l hemorrhage (ICH). Methods. The authors studied 108 patients with acu te hyperintensive ICH. Imaging modalities included noncontrast-enhance d computerized tomography (CT) scanning, gadolinium-enhanced MR imagin g, and conventional cerebral angiography obtained within 6 hours after the onset of hemorrhage. A repeated CT scan was obtained within 48 ho urs to evaluate enlargement of the hematoma. Findings on MR imaging in dicating extravasation, including any high-intensity signals on T-1-we ighted postcontrast images, were observed in 39 patients, and 17 of th ese also showed evidence of extravasation on cerebral angiography. The presence of extravasation on MR imaging was closely correlated with e vidence of hematoma enlargement on follow-up CT scans (p < 0.001). Con clusions. Evidence of extravasation documented on MR imaging indicates persistent hemorrhage and correlates with enlargement of the hematoma .