Hemorrhage on MRI
Updates to Article Attributes
Body
was changed:
The imaging characteristics of blood on MRI are variable and change with the age of the blood.
In general, five stagesof haematoma evolution are recognised:
-
hyperacute
- intracellular oxyhaemoglobin
- isointense on T1
- isointense to hyperintense on T2
-
acute (1 to 2 days)
- intracellular deoxyhaemoglobin
- T2 signal intensity drops (T2 shortening)
- T1 remains intermediate-to-long
-
early subacute (2 to 7 days)
- intracellular methaemoglobin
- T1 signal gradually increases (T1 shortening) to become hyperintense
-
late subacute (7 to 14-28 days)
- extracellular methaemoglobin: over the next few weeks, as cells break down, extracellular methaemoglobin leads to an increase in T2 signal
also
- extracellular methaemoglobin: over the next few weeks, as cells break down, extracellular methaemoglobin leads to an increase in T2 signal
-
chronic (>14-28 days)
- periphery
- intracellular haemosiderin
- low on both T1 and T2
- center
- extracellular hemichromes
- isointense on T1, hyperintense on T2
- periphery
Practical points
- extracranial blood products age differently than intracranial blood products, and extracranial hematomas often have a heterogeneous appearance, confounding attempts at reliably dating the age of an extracranial hemorrhage 3,4
-<strong>late subacute</strong> (7 to 14-28 days)<ul><li>extracellular methaemoglobin: over the next few weeks, as cells break down, extracellular methaemoglobin leads to an increase in T2 signal also</li></ul>- +<strong>late subacute</strong> (7 to 14-28 days)<ul><li>extracellular methaemoglobin: over the next few weeks, as cells break down, extracellular methaemoglobin leads to an increase in T2 signal </li></ul>
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