Diffusion-weighted signal patterns of intracranial haemorrhage

J. S. Whang, M. Kolber, D. K. Powell, E. Libfeld

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

The signal pattern of intracranial haemorrhage on diffusion-weighted imaging (DWI) as it evolves over time is rarely discussed due to the sensitivity of T2-weighted sequences and the specificity of classic signal patterns on T1 and T2-weighted sequences. The DWI signal is strongly affected by the magnetic susceptibility of paramagnetic blood products and, therefore, is markedly hypointense in the same phases that demonstrate hypointensity on T2-weighted sequences; however, hyperacute haemorrhage (oxyhaemoglobin-predominant clot) and late subacute haemorrhage (extracellular methaemoglobin) do not demonstrate T2 hypointensity. Moreover, T2-weighted sequences are less sensitive to the presence of extra-axial haemorrhage than to intraparenchymal haemorrhage. At these stages of evolution, haemorrhage demonstrates high DWI signal in association with low ADC values, which may be more pronounced than even its corresponding fluid-attenuated inversion recovery (FLAIR) signal. DWI is useful for identifying hyperacute subarachnoid haemorrhage and as a problem-solving tool in challenging cases.

Original languageEnglish (US)
Pages (from-to)909-916
Number of pages8
JournalClinical Radiology
Volume70
Issue number8
DOIs
StatePublished - Jan 1 2015
Externally publishedYes

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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