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首页> 外文期刊>JAMA: the Journal of the American Medical Association >Comparison of MRI and CT for detection of acute intracerebral hemorrhage.
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Comparison of MRI and CT for detection of acute intracerebral hemorrhage.

机译：MRI和CT在急性脑出血检测中的比较。

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CONTEXT: Noncontrast computed tomography (CT) is the standard brain imaging study for the initial evaluation of patients with acute stroke symptoms. Multimodal magnetic resonance imaging (MRI) has been proposed as an alternative to CT in the emergency stroke setting. However, the accuracy of MRI relative to CT for the detection of hyperacute intracerebral hemorrhage has not been demonstrated. OBJECTIVE: To compare the accuracy of MRI and CT for detection of acute intracerebral hemorrhage in patients presenting with acute focal stroke symptoms. DESIGN, SETTING, AND PATIENTS: A prospective, multicenter study was performed at 2 stroke centers (UCLA Medical Center and Suburban Hospital, Bethesda, Md), between October 2000 and February 2003. Patients presenting with focal stroke symptoms within 6 hours of onset underwent brain MRI followed by noncontrast CT. MAIN OUTCOME MEASURES: Acute intracerebral hemorrhage and any intracerebral hemorrhage diagnosed on gradient recalled echo (GRE) MRI and CT scans by a consensus of 4 blinded readers. RESULTS: The study was stopped early, after 200 patients were enrolled, when it became apparent at the time of an unplanned interim analysis that MRI was detecting cases of hemorrhagic transformation not detected by CT. For the diagnosis of any hemorrhage, MRI was positive in 71 patients with CT positive in 29 (P<.001). For the diagnosis of acute hemorrhage, MRI and CT were equivalent (96% concordance). Acute hemorrhage was diagnosed in 25 patients on both MRI and CT. In 4 other patients, acute hemorrhage was present on MRI but not on the corresponding CT--each of these 4 cases was interpreted as hemorrhagic transformation of an ischemic infarct. In 3 patients, regions interpreted as acute hemorrhage on CT were interpreted as chronic hemorrhage on MRI. In 1 patient, subarachnoid hemorrhage was diagnosed on CT but not on MRI. In 49 patients, chronic hemorrhage, most often microbleeds, was visualized on MRI but not on CT. CONCLUSION: MRI may be as accurate as CT for the detectionof acute hemorrhage in patients presenting with acute focal stroke symptoms and is more accurate than CT for the detection of chronic intracerebral hemorrhage.
机译：背景：非对比计算机断层扫描（CT）是对具有急性中风症状的患者进行初步评估的标准脑成像研究。已经提出了多模式磁共振成像（MRI）作为紧急中风设置中CT的替代方法。但是，尚未证实MRI相对于CT的准确性，可检测出超急性脑出血。目的：比较MRI和CT检查对有急性中风症状的急性脑出血的准确性。设计，地点和患者：2000年10月至2003年2月间，在两个卒中中心（加州大学洛杉矶分校医学中心和郊区医院，贝塞斯达，马里兰州）进行了一项前瞻性，多中心研究。脑部MRI，然后进行非对比CT。主要观察指标：经4位盲人的共识，在经梯度回诊（GRE）MRI和CT扫描后确诊的急性脑出血和任何脑出血。结果：这项研究在200名患者入组后提早停止，当时在一项计划外的中期分析中发现MRI正在检测未通过CT检测到的出血性转化病例。对于任何出血的诊断，MRI阳性的71例患者中CT阳性的29例（P <.001）。对于急性出血的诊断，MRI和CT相当（一致性为96％）。 MRI和CT均诊断出25例急性出血。在其他4名患者中，MRI上出现了急性出血，但在相应的CT上却没有-这4例中的每例都被解释为缺血性梗死的出血性转化。在3例患者中，在CT上被解释为急性出血的区域在MRI上被解释为慢性出血。在1例患者中，CT确诊为蛛网膜下腔出血，而MRI确诊。在49例患者中，慢性出血（通常为微出血）在MRI上可见，而在CT上不可见。结论：对于具有急性局灶性中风症状的患者，MRI的准确度可能与CT一样，而对慢性脑出血的准确度要比CT准确。

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