Quantitative Study Of Differential Diagnosis Between Cerebral Hemorrhage And Calcification By Using T2~* -weighted Gradient-echo MRI

Objective: To study the quantitative criterion of the differential diagnosis between cerebral hemorrhage and calcification by using T2~*-weighted gradient-echo sequence of MR .Methods: The part of laboratory:4 cases of the volunteers were punctured for sampling 10ml blood from radial artery, put collected blood into collection tube Immediately, sealed under steriled conditions in 14-packing sterile plastic sample tube under 37℃. The sample was scanned about The T2~*-weighted gradient-echo sequence,T1WI sequences, T2WI sequence, T2-FLAIR sequence, DWI sequence and SWAN sequence every 12 hours, and biochemical analysis of parallel samples were taken at the same time, recorded the content of hemoglobin and matheamalbmin(MHB). T2~* values was measured and calculated in different periods,analyzed and compared the T2~* values statistically. The part of clinical: The diagnostic golden standard of hemorrhage was based on SWAN .The diagnostic golden standard of calcification was based on its demonstration on CT. The T2~*- weighted gradient-echo sequence with TE of 15ms and 30ms was performed in 18 cases (38 lesions) of cerebral hematoma and 7cases (11 lesions) of calcification. The T2~*value of the same dark area was recorded at different TE values, For some cases of subacute hemorrhage (diameter greater than 25mm) can be divided into core and peripheral areas, Peripheral Ring outside low signal for the peripheral area, measured the core and peripheral S1, S2 value, measured and calculated calcification and different core and peripheral T2~*values , which were analyzed and compared statistically.Results:1 The part of laboratory: the MHB content is increased dynamically, and there is no strict boundaries of phases, where the signal change occurs gradually 72 hours before ,The blood samples with high iron content of hemoglobin was positively related to T2~* values , At 72-84 hours a sharp decline occurs to T2~* values.2 The part of clinical: The T2~*-weighted gradient-echo sequence discovery rate of cerebral hemorrhage is 1.9 times than CT.3 The part of clinical: Subacute hematoma of T2~*-weighted gradient-echo sequence has three components.4 The part of clinical: The T2~*value at different TE values were recorded that cerebral hemorrhage (core area)=0.052±0.014. cerebral hemorrhage (peripheral area)= 0.037±0.018,calcification=0.025±0.015.5 The part of clinical: The T2~*value at different TE values is statistically different between cerebral hemorrhage (core area) and calcification (P<0.001) of group cerebral hemorrhage. The T2~*value at different TE values is not statistically different between group cerebral hemorrhage (peripheral area) and calcification (P>0.05).Conclusion:1 The part of laboratory: Blood samples MHB content in vitro with T2~* values are parallel.At72-84 hours not parallel, so It is difficult using the T2~* value to stage the hematoma;2 The part of clinical: The T2~*-weighted gradient-echo sequence discovery rate of cerebral hemorrhage is higher than CT, especially for micro- hemorrhage and posterior fossa such as brain stem, cerebellum and other parts bleeding, there is a obviously advantage than CT;3 The quantitatively differential diagnosis between acute cerebral hematoma and calcification is available by the T2~* value at different TE values, it will contribute to a one-shop MR diagnosis of cerebrovascular disease.