Diffusion-weighted magnetic resonance imaging for spontaneous intracerebral hemorrhage
Diffusion-weighted magnetic resonance imaging (DWI) may be considered as the initial screening tool for imaging patients presenting with focal neurologic symptoms suggestive of stroke.
A study of Shiga et al. found an association between the presence of cnm-positive Streptococcus mutans and DWI hyperintensities in patients with acute intracerebral hemorrhage 1).
DW-MRI at b1000 has a diagnostic yield similar to noncontrast computed tomography (NCCT) for detecting ICH and superior to NCCT for detecting ischemic stroke (IS). Therefore, DW-MRI may be considered as the initial screening tool for imaging patients presenting with focal neurologic symptoms suggestive of stroke 2).
1)
Shiga Y, Aoki S, Hosomi N, Nomura R, Nakamori M, Nezu T, Tachiyama K, Kamimura T, Kinoshita N, Shimomura R, Hayashi Y, Matsushima H, Imamura E, Ueno H, Wakabayashi S, Nakano K, Kohriyama T, Maruyama H. Cnm-positive Streptococcus mutans and diffusion-weighted imaging hyperintensities in acute intracerebral hemorrhage. Eur J Neurol. 2021 Jan 11. doi: 10.1111/ene.14725. Epub ahead of print. PMID: 33426742.
2)
Keigler G, Goldberg I, Eichel R, Gomori JM, Cohen JE, Leker RR.
Diffusion-weighted Imaging at b1000 for Identifying Intracerebral Hemorrhage:
Preliminary Sensitivity, Specificity, and Inter-rater Variability. J Stroke
Cerebrovasc Dis. 2014 May 1. pii: S1052-3057(14)00065-2. doi:
10.1016/j.jstrokecerebrovasdis.2014.02.005. [Epub ahead of print] PubMed PMID:
24795096.