Comparison of five MR sequences for the detection of acute intracranial hemorrhage

Purpose: To evaluate the respective value of 5 MR sequences to distinguish between stroke patients with and without acute intracerebral hemorrhage (ICH). Methods: MR images obtained <= 6 h after stroke onset of 86 patients ( 43 ICH, 43 non- ICH) were reviewed by 3 observers who looked for signs of acute ICH on each image set [T-1 and T-2 gradient echo (GRE), FLAIR, T-2-EPI and DWI], presented separately. Results: For the identification of ICH, intraobserver and interobserver concordance were at least kappa = 0.95 for all sequences. Of all interpretations, 7 (0.4%) were erroneous, with sensitivity and specificity of FLAIR, T-2 - EPI and DWI reaching 100%; GRE sensitivity and specificity were 100% and 95 - 97.5%, respectively; T-1 sensitivity and specificity were 97.3 - 100% and 97.4 100%, respectively. All 4 patients misclassified on one pulse sequence were correctly classified on all the other sequences. Conclusion: In the setting of acute stroke, each of the 5 studied sequences enables ICH and non-ICH patients to be distinguished with high sensitivity and specificity. Copyright (C) 2005 S. Karger AG, Basel