Detection of hyperacute parenchymal hemorrhage of the brain using echo-planar T2*-weighted and diffusion-weighted MRI

We investigated the usefulness of echo-planar imaging (EPI) as well as T2*- weighted and diffusion-weighted MRI (DWI) to identify hyperacute hemorrhage (within 24 h after ictus) in the brain. Seven patients were examined 3.5 t o 24 h after onset of symptoms using a whole-body 1.5-T MR system. Two diff usion-weighted sequences were run to obtain isotropic and anisotropic diffu sion images. Apparent diffusion coefficients (ADC) were calculated from the isotropic diffusion images. All DWI images as well as the T2*-weighted EPI images showed the hematomas as either discrete, deeply hypointense homogen eous lesions, or as lesions of mixed signal intensity containing hypointens e areas. We conclude that even in the early phase after hemorrhage, suffici ent amounts of paramagnetic deoxyhemoglobin are present in intracerebral he morrhages to cause hypointensity on EPI T2*-weighted and DWI images; thus, use of ultrafast EPI allows identification of intracerebral hemorrhage.