Comparison of Magnetic Resonance Imaging Sequences With Computed Tomography to Detect Low-Grade Subarachnoid Hemorrhage: Role of Fluid-Attenuated Inversion Recovery Sequence

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Abstract

Objectives:

To compare computed tomography (CT) with magnetic resonance imaging (MRI) for the presumptive diagnosis and localization of acute and subacute low-grade subarachnoid hemorrhage (SAH).

Methods:

We consecutively enrolled 45 patients clinically suspected of low-grade SAH, comparing them with a control group. We obtained axial nonenhanced CT scans as well as fluid-attenuated inversion recovery (FLAIR) and T2-weighted gradient echo (T2*) MRI sequences at 1.0 T. Two neuroradiologists scrutinized the presence of blood at 26 different regions in the intracranial subarachnoid space (SAS).

Results:

Three of 45 patients had normal CT and MRI scans, and SAH was excluded by lumbar puncture. We demonstrated SAH on CT scans in 28 of 42 (66.6%) patients, T2* sequences in 15 of 42 (35.7%) patients, and FLAIR sequences in 42 of 42 (100%) patients. Fluid-attenuated inversion recovery sequences were superior to CT in 16 of the 26 evaluated regions.

Conclusions:

The FLAIR sequence was superior for presumptive diagnosis and localization of acute and subacute low-grade SAH, representing a potential tool in this setting.

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