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

Cerebrovasc Dis. 2005;20(5):388-94. doi: 10.1159/000088669. Epub 2005 Oct 3.


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 < or =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.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Aged
  • Aged, 80 and over
  • Female
  • Humans
  • Intracranial Hemorrhages / pathology*
  • Magnetic Resonance Imaging* / statistics & numerical data
  • Male
  • Middle Aged
  • Observer Variation
  • Retrospective Studies
  • Sensitivity and Specificity
  • Stroke / pathology*