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Hemorrhage on MRI

Changed by Zishan Sheikh, 9 Sep 2015
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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:

  1. hyperacute
    • intracellular oxyhaemoglobin
    • isointense on T1
    • isointense to hyperintense on T2
  2. acute (1 to 2 days)
    • intracellular deoxyhaemoglobin
    • T2 signal intensity drops (T2 shortening)
    • T1 remains intermediate-to-long
  3. early subacute (2 to 7 days)
    • intracellular methaemoglobin
    • T1 signal gradually increases (T1 shortening) to become hyperintense
  4. 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 
  5. chronic (>14-28 days)
    • periphery
      • intracellular haemosiderin
      • low on both T1 and T2
    • center
      • extracellular hemichromes
      • isointense on T1, hyperintense on T2

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

See also
  • -<p>The imaging characteristics of <strong>blood on MRI</strong> are variable and change with the age of the blood.</p><p>In general, five stages<strong> </strong>of haematoma evolution are recognised:</p><ol>
  • -<li>
  • -<strong>hyperacute </strong><ul>
  • -<li>intracellular oxyhaemoglobin</li>
  • -<li>isointense on T1</li>
  • -<li>isointense to hyperintense on T2</li>
  • -</ul>
  • -</li>
  • -<li>
  • -<strong>acute</strong> (1 to 2 days)<ul>
  • -<li>intracellular deoxyhaemoglobin</li>
  • -<li>T2 signal intensity drops (T2 shortening)</li>
  • -<li>T1 remains intermediate-to-long</li>
  • -</ul>
  • -</li>
  • -<li>
  • -<strong>early subacute</strong> (2 to 7 days)<ul>
  • -<li>intracellular methaemoglobin</li>
  • -<li>T1 signal gradually increases (T1 shortening) to become hyperintense</li>
  • -</ul>
  • -</li>
  • -<li>
  • -<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>
  • -</li>
  • -<li>
  • -<strong>chronic</strong> (&gt;14-28 days)<ul>
  • -<li>periphery<ul>
  • -<li>intracellular haemosiderin</li>
  • -<li>low on both T1 and T2</li>
  • -</ul>
  • -</li>
  • -<li>center<ul>
  • -<li>extracellular hemichromes</li>
  • -<li>isointense on T1, hyperintense on T2</li>
  • -</ul>
  • -</li>
  • -</ul>
  • -</li>
  • -</ol><h4>Practical points</h4><ul><li>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 <sup>3,4</sup>
  • -</li></ul>
  • +<p>The imaging characteristics of <strong>blood on MRI</strong> are variable and change with the age of the blood.</p><p>In general, five stages<strong> </strong>of haematoma evolution are recognised:</p><ol>
  • +<li>
  • +<strong>hyperacute </strong><ul>
  • +<li>intracellular oxyhaemoglobin</li>
  • +<li>isointense on T1</li>
  • +<li>isointense to hyperintense on T2</li>
  • +</ul>
  • +</li>
  • +<li>
  • +<strong>acute</strong> (1 to 2 days)<ul>
  • +<li>intracellular deoxyhaemoglobin</li>
  • +<li>T2 signal intensity drops (T2 shortening)</li>
  • +<li>T1 remains intermediate-to-long</li>
  • +</ul>
  • +</li>
  • +<li>
  • +<strong>early subacute</strong> (2 to 7 days)<ul>
  • +<li>intracellular methaemoglobin</li>
  • +<li>T1 signal gradually increases (T1 shortening) to become hyperintense</li>
  • +</ul>
  • +</li>
  • +<li>
  • +<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>
  • +</li>
  • +<li>
  • +<strong>chronic</strong> (&gt;14-28 days)<ul>
  • +<li>periphery<ul>
  • +<li>intracellular haemosiderin</li>
  • +<li>low on both T1 and T2</li>
  • +</ul>
  • +</li>
  • +<li>center<ul>
  • +<li>extracellular hemichromes</li>
  • +<li>isointense on T1, hyperintense on T2</li>
  • +</ul>
  • +</li>
  • +</ul>
  • +</li>
  • +</ol><h4>Practical points</h4><ul><li>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 <sup>3,4</sup>
  • +</li></ul>
  • +<h4>See also</h4><ul>
  • +<li><a href="/articles/ageing-blood-on-mri-mneuomonic"> ageing blood on MRI (mnemonic)</a></li>
  • +</ul>

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