Key result
Echoplanar susceptibility-weighted MRI detects hyperacute intraparenchymal hemorrhage within hours of stroke onset.
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To the Editor: Hacke and Warach1 evaluated the role of MRI in acute stroke. I agree that the ideal neuroimaging protocol in acute stroke should be sensitive in excluding intracranial hemorrhage. CT has been the preferred method of detecting acute hemorrhage because of its depiction of clotted blood as high density against the darker brain tissue. Conventional MRI techniques are insensitive to certain forms of bleeding.2-3⇓ With the advent of echoplanar MRI, it is possible to detect acute intraparenchymal hemorrhage (IPH) using susceptibility-weighted imaging (SWI).2 Echoplanar SWI relies on the detection of deoxyhemoglobin (hypointensity) that develops in IPH in the first few hours after vascular rupture.3 Hacke and Warach1 thus recommend in their editorial that an MRI examination that includes diffusion, perfusion, MR angiography, T2-weighted MRI, and SWI is sufficient for the acute stroke setting and would obviate the need for CT. Although I agree …
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Hacke et al. (2000) conducted a letter in Acute stroke. Echoplanar susceptibility-weighted imaging (SWI) and multiparametric MRI vs. Computed tomography (CT) was evaluated. Echoplanar susceptibility-weighted MRI can detect acute intraparenchymal hemorrhage in the first few hours after vascular rupture in acute stroke, though no quantitative trial data are reported.
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