Hemorrhage imaging

Fig. 25.2. Oblique transversal reformatted volume-rendered multi-detector row CT angiogram with a superior cut of a patient suffering from a subarachnoidal hemorrhage. Image shows a giant aneurysm of the right median cerebral artery (black asterisk) with a small daughter aneurysm (long arrow). There are two other small aneurysms, one in the posterior branch of the median cerebral artery (short arrow) and the other in the anterior communicating cerebral artery (arrowhead)...

The clinical role of permeability imaging has yet to be assessed by a large clinical trial, but these techniques continue to hold promise for the future, as intracranial hemorrhage is the most significant potential complication of what is currently the only FDA-approved treatment for acute stroke. 

Kassner A, Roberts T, Taylor K, Silver F, Mikulis D. Prediction of hemorrhage in acute ischemic stroke using permeability MR imaging. Am J Neuroradiol 2005 26 2213-2217. 

Dijkhuizen RM, Asahi M, Wu O, Rosen BR, Lo EH. Delayed rt-PA treatment in a rat embolic stroke model Diagnosis and prognosis of ischemic injury and hemorrhagic transformation with magnetic resonance imaging. J Cereb Blood Flow Metab. 2001 21 964-971. 

Greer DM, Koroshetz WJ, Cullen S, Gonzalez RG, Lev MH. Magnetic resonance imaging improves detection of intracerebral hemorrhage over computed tomography after intra-arterial thrombolysis. Stroke 2004 35 491 95. 

All patients should have a brain computed tomography scan or magnetic resonance imaging scan to differentiate an ischemic stroke from a hemorrhagic stroke, as the treatment... 

Splinter hemorrhage Linear image under the nail beds caused by local hemorrhage as a result of hand trauma or endocarditis. 

K2. Kalvach, R, Adam, R, Fayad, R, Dickey, R, and Kisiel, D., Imaging, transcranial Doppler and CSF cytology in subarachnoid hemorrhage. In 1st American-Czech and Slovak Neuroscience Symposium. 5, (1993). 

Noninvasive detection of vascular abnormalities is of the utmost importance in clinical imaging. Indeed, a lot of injuries and diseases manifest themselves through modifications of the vasculature [1,2]. For example, abnormal angiogenesis (blood vessel growth) is observed in the development of most tumors. Embolism and atherosclerosis also manifest themselves through alterations of the blood vessels, namely through occlusions. Hemorrhage could also be detected noninvasively, which is crucial in injuries or in diseases such as ulcers [1]. 

Lin DD, Filippi CG, Steever AB, Zimmerman RD (2001) Detection of intracranial hemorrhage comparison between gradient-echo images and b(0) images obtained from diffusion-weighted echo-planar sequences. AJNR Am J Neuroradiol 22 1275-1281... 

N, Ross JS, Ding XP, Ruggieri PM, Shearer DM, Khajavi K, Masaryk TJ (1999) Hemorrhage detected using MR imaging in the setting of acute stroke an in vivo model. AJNR Am J Neuroradiol 20 1863-1870... 

Alternatively, a better preselection of patients who may benefit from thrombolytic therapy or who may suffer from hemorrhagic complications, is an appealing approach. The idea is to characterize ischemic tissue subareas by information from DWI, PI, MRS, Tl- or T2-weighted images in order to estimate the volume of tissue at-risk that may profit from recanalization. We have already reviewed the mismatch... 

Knight RA, Barker PB, Fagan SC, Li Y, Jacobs MA, Welch KM (1998) Prediction of impending hemorrhagic transformation in ischemic stroke using magnetic resonance imaging in rats. Stroke 29 144-151... 

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