Purpose: The aim of this study was to determine the value of different magnetic resonance imaging (MRI) sequences for the diagnosis of intraventricular hemorrhages (IVHs).
Patients and methods: The study included 22 consecutive patients with computed tomography (CT) proven IVH in which an MR examination had been performed. Proton-density-(PD-), T2-, fluid-attenuated inversion-recovery (FLAIR), T1- and T2*-weighted images were evaluated retrospectively by two neuroradiologists regarding presence and anatomical distribution of IVH, and cerebrospinal fluid (CSF) flow artifacts. CT was used as gold standard.
Results: According to CT, IVH was located in the right/left lateral ventricles in 16/17 patients, in the third ventricle in seven and in the fourth ventricle in twelve cases. PD- and T2*-weighted images both showed a 100% sensitivity and specificity for the overall diagnosis of IVH, and a high sensitivity for the detection of IVH in all four ventricles. The sensitivity of T1-, T2- and FLAIR- weighted images for the overall presence of an IVH was 77%, 85%, and 93%, respectively, with specificities of 100%. CSF flow artifacts occurred predominantly in the third and fourth ventricles. While FLAIR- and T2-weighted sequences were especially prone to this phenomenon, T1-, T2*- and PD-weighted images showed a higher resistance to those artifacts.
Conclusion: This study demonstrates a high sensitivity of PD- and T2*-weighted images in the detection of IVH. On the contrary, T2-, T1- and FLAIR-weighted sequences were not suitable for a reliable detection of IVH.