To explore the correlation between hematoma expansion within 24 hours of hypertensive intracerebral hemorrhage and signs on nonenhanced computed tomography(NECT). Methods The clinical data and CT images of 185 patients with hypertensive intracerebral hemorrhage were retrospectively analyzed.The differences in CT parameters were compared between the expansion group and the unexpanded group.Binary logistic regression analysis was performed on the indicators with statistical significance between the two groups to identify the potential correlation between CT parameters and hematoma expansion.The roles of blend sign,lobulation sign,and black hole sign in predicting early hematoma expansion were assessed. Results The CT quantitative data including initial volume,maximum diameter,minimum diameter,maximum CT value,mean CT value,difference between maximum diameter and minimum diameter showed no significant difference between these two group(all >0.05).CT qualitative data including blend sign,lobulation sign,and black hole sign were significantly different(<0.05)but the differences became not significant after the hematoma broke into the ventricles.Binary logistic regression analysis showed that blend sign,lobulation sign,and black hole sign were independent risk factors for early hematoma expansion,with sensitivity,specificity,positive predictive value,and negative predictive value of the combined signs and the early hematoma expansion calculated by the four-fold table method being 78.4%,59.0%,42.1%,and 87.8%,respectively,and the Youden index was 0.374.Its Youden index was closer to 1 than the blend sign,the black hole sign,and the lobulation sign. Conclusion The blend sign,lobulation sign,and black hole sign in NECT can be used to predict hematoma expansion within 24 hours after hypertensive cerebral hemorrhage.
Cerebral Hemorrhage ; diagnostic imaging ; Hematoma ; diagnostic imaging ; Humans ; Intracranial Hemorrhage, Hypertensive ; diagnostic imaging ; Retrospective Studies ; Tomography, X-Ray Computed

Adrenal hemorrhage following blunt abdominal trauma is extremely rare. Most of the lesions are unilateral and right sided. Although often asymptomatic, life-threatening adrenal insufficiency may develop in the bilateral adrenal gland hemorrhage. Isolated adrenal injuries are very rare. They are often associated with other organ injuries. The mortality rates of patients range from 7% to 32%. In this report, we present the computed tomography and magnetic resonance imaging findings of unilateral adrenal hemorrhages in two patients with a history of fall from a height.
Abdominal Injuries ; diagnostic imaging ; Adrenal Gland Diseases ; diagnostic imaging ; Adult ; Hemorrhage ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Male ; Tomography, X-Ray Computed ; Wounds, Nonpenetrating ; diagnostic imaging

This study was conducted to assess time-sensitive magnetic resonance (MR) changes in canine blood using low-field MR. Arterial and venous blood samples were collected from eight healthy beagle dogs. Samples were placed in 5-mL tubes and imaged within 3 hours of collection at 1 day intervals from day 1 to day 30. The following sequences were used: T1-weighted (T1W), T2-weighted (T2W), fluid-attenuated inversion recovery (FLAIR), short tau inversion recovery (STIR), and T2-star gradient-echo (T2*-GRE). Visual comparison of the images revealed that four relatively homogenous blood clots and twelve heterogeneous blood clots developed. The margination of the clot and plasma changed significantly on day 2 and day 13. On day 2, heterogeneous blood clots were differentiated into 2 to 3 signal layers in the T2W, T1W, and especially the STIR images. Hypointense signal layers were also detected in the blood clots in STIR images, which have T2 hypo, FLAIR hypo, and T1 hyper intense signals. In all images, these signal layers remained relatively unchanged until day 13. Overall, the results suggest that hematomas are complex on low-field MRI. Accordingly, it may not be feasible to accurately characterize hemorrhages and predict clot age based on low-field MRI.
Animals ; Blood/*diagnostic imaging ; Blood Coagulation ; Blood Physiological Phenomena ; Dogs ; Female ; Hematoma/diagnostic imaging ; Hemorrhage/diagnostic imaging ; *Magnetic Resonance Imaging ; Thrombosis/diagnostic imaging ; Time

OBJECTIVETo investigate the difference in the vulnerability of carotid atherosclerotic plaques in patients with unilateral and bilateral intraplaque hemorrhage (IPH).

METHODSA retrospective analysis was conducted among 44 patients with unilateral IPH (30 cases) or bilateral IPH (14 cases) in the carotid plaques detected by magnetic resonance imaging (MRI) in our hospital between December, 2009 and December, 2012. The age, maximum wall thickness and incidence of fibrous cap rupture were compared between the two groups.

RESULTSCompared with those with unilateral IPH, the patients with bilateral IPHs had a significantly younger age (66.6∓9.4 years vs 73.7∓9.0 years, P=0.027), a significantly greater maximum plaque thickness (6.3∓1.9 mm vs 5.0∓1.3 mm, P=0.035) and a higher incidence of ulcers (50% vs 13.3%, P=0.025). Logistic regression analysis revealed a significant association between bilateral IPHs and the occurrence of ulcer with an odd ratio (OR) of 6.5 (95% confidence interval [CI]: 1.5-28.7, P=0.014). After adjustment for gender in Model 1, bilateral IPHs were still significantly associated with presence of ulcer (OR=5.7, 95%CI: 1.1-29.2, P=0.036). But after adjustment for age (P=0.131) or maximum plaque thickness (P=0.139) in model 2, no significant correlation was found between bilateral IPHs and the presence of ulcer.

CONCLUSIONCompared with patients with unilateral IPH, those with bilateral IPHs are at a younger age and have a greater plaque burden and a higher incidence of fibrous cap rupture, suggesting a greater vulnerability of the carotid plaques in patients with bilateral IPHs.

Aged ; Carotid Arteries ; diagnostic imaging ; Carotid Stenosis ; diagnostic imaging ; physiopathology ; Fibrosis ; Hemorrhage ; diagnostic imaging ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Odds Ratio ; Plaque, Atherosclerotic ; diagnostic imaging ; Retrospective Studies

Humans ; Data Warehousing ; East Asian People ; Intracranial Hemorrhages/diagnostic imaging* ; Asian People ; Cerebral Hemorrhage/diagnostic imaging*

Adult ; Basal Ganglia Hemorrhage ; complications ; diagnostic imaging ; Humans ; Hypohidrosis ; diagnostic imaging ; etiology ; Intracranial Arteriovenous Malformations ; complications ; diagnostic imaging ; Intracranial Hemorrhages ; complications ; diagnostic imaging ; Magnetic Resonance Imaging ; Male ; Rupture ; Thalamus ; diagnostic imaging ; Third Ventricle ; diagnostic imaging ; Tomography, Optical Coherence

Intracranial vertebrobasilar artery (VBA) dissection can be classified into three major clinical types: subarachnoid hemorrhage, headache, and nonhemorrhagic ischemic symptoms. And it has been more frequently identified since the introduction of advanced diagnostic imaging modalites including MR angiography and multidetector CT angiography. Aggressive treatment has been considered due to their tendency for early rebleeding and a fatal natural course. We describe approproiate neurointerventional options, based on he patterns of angiographic features and location of dissection.
Angiography ; Arteries* ; Diagnostic Imaging ; Embolization, Therapeutic ; Headache ; Subarachnoid Hemorrhage

BackgroundCompared with full-term infants, very preterm infants are more vulnerable to injury and long-term disability and are at high risk of death. The predictive value of ultrasound and imaging on the neurodevelopment is one of the hot topics. This study aimed to investigate the relationship between cranial ultrasound (cUS) variables and neurodevelopmental outcomes of very preterm infants.

MethodsTotally 129 very preterm infants (gestational age ≤28 weeks) in neonatal intensive care unit of Hunan Children's Hospital between January 2012 and November 2014 were included in this retrospective study. Serial cUS (weekly before discharge and monthly after discharge) was performed on the infants until 6 months or older. Magnetic resonance imaging (MRI) was performed on the infants at approximately the term-equivalent age. The mental developmental index (MDI) and psychomotor developmental index (PDI) were followed up until the infants were 24 months or older. The relationship between brain injury and MDI/PDI scores was analyzed.

ResultsThe consistency rate between cUS and MRI was 88%. At the first cUS, germinal matrix hemorrhage (GMH) Grades 3 and 4, hospitalization duration, and weight are significantly correlated with MDI/PDI and prognosis (MDI: odds ratio [OR] = 8.415, 0.982, and 0.042, P = 0.016, 0.000, and 0.004; PDI: OR = 7.149, 0.978, and 0.012, P = 0.025, 0.000, and 0.000, respectively). At the last cUS, gestational age, extensive cystic periventricular leukomalacia (c-PVL), and moderate and severe hydrocephaly are significantly correlated with MDI (OR = 0.292, 60.220, and 170.375, P = 0.004, 0.003, and 0.000, respectively). Extensive c-PVL and moderate and severe hydrocephaly are significantly correlated with PDI (OR = 76.861 and 116.746, P = 0.003 and 0.000, respectively).

ConclusionsVery premature infants with GMH Grades 3 and 4, short hospitalization duration, and low weight have low survival rates and poorly developed brain nerves. Cerebral palsy can result from severe cerebral hemorrhage, moderate and severe hydrocephaly, and extensive c-PVL. The sustained, inhomogeneous echogenicity of white matter may suggest subtle brain injury.

Brain ; diagnostic imaging ; Brain Injuries ; diagnostic imaging ; Cerebral Hemorrhage ; diagnostic imaging ; Echoencephalography ; Female ; Gestational Age ; Humans ; Hydrocephalus ; diagnostic imaging ; Infant, Premature ; Infant, Premature, Diseases ; diagnostic imaging ; Magnetic Resonance Imaging ; Pregnancy ; Retrospective Studies

Male ; Humans ; Urinary Bladder/diagnostic imaging* ; Prostate/diagnostic imaging* ; Multiparametric Magnetic Resonance Imaging ; Cystitis/diagnostic imaging* ; Hemorrhage/etiology* ; Urinary Bladder Neoplasms/complications*

Dural tears can occur during spinal surgery and may lead to cerebrospinal fluid (CSF) leakage which is rarely involved in remote cerebellar hemorrhage. Only a few of cases of simultaneous cerebral and cerebellar hemorrhage have been reported in the English literature. We experienced a case of multiple remote cerebral and cerebellar hemorrhages in a 63-year-old man who exhibited no significant neurologic deficits after spinal surgery. Magnetic resonance imaging (MRI) performed 4 days after the surgery showed a large amount of CSF leakage in the lumbosacral space. The patient underwent the second surgery for primary repair of the dural defect, but complained of headache after dural repair surgery. Brain MRI taken 6 days after the dural repair surgery revealed multifocal remote intracerebral and cerebellar hemorrhages in the right temporal lobe and both cerebellar hemispheres. We recommend diagnostic imaging to secure early identification and treatment of this complication in order to prevent serious neurologic deficits.
Brain ; Diagnostic Imaging ; Headache ; Hemorrhage ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Neurologic Manifestations ; Temporal Lobe