Different brain haemorrhage period MRI performance, do you have it?

!---- Ct and MRI can be called "double male" in a diagnostic examination for cerebral hemorrhage, each with its own strengths.clinically proposed cases of acute intracrany haemorrhage can be preferred CT examination, for subacute or chronic hematoma, MRI examination is more sensitive than CT, the cause of bleeding is better than CT, MRI can be preferred.this article will lead you to learn the evolution of cerebral hemorrhage, and in essence explain the performance of MRI in different periods of cerebral hemorrhage, so that we can have a further understanding of cerebral hemorrhage disease.the evolution of cerebral hemorrhage process the performance of MRI at different times is related to changes in red blood cells and hemoglobin, we first understand the process of hemoglobin evolution in hematoma after brain haemorrhage.▎ red blood cells and hemoglobin hemoglobin is a double concave disc, is the largest number of blood cells in the blood, hemoglobin (hemoglobin, Hb) is the most abundant protein components in the red blood cells, the main function is transport O2 and CO2.Hb consists of globulin and hemoglobin, which binds the iron ions in hemoglobin to Fe2 plus.the following concepts are often confusing, please be clear: oxyhemoglobin (oxyhemoglobin, HbO2): O2 binds to Hb protein to form oxygenated hemoglobin, and the iron ions in oxygenhemoglobin are Fe2 plus, because this process occurs with oxygen co-operative use, not oxidation.deoxyhemoglobin: Hemoglobin or hemoglobin that is not bound to O2 after the release of O2 in HbO2 is called deoxygenated hemoglobin, and the iron ions in the same deoxygenated hemoglobin are also Fe2 plus.high-iron hemoglobin( mitamoglobin): When the iron ions in hemoglobin lose an electron, i.e. oxidized to Fe3, it is called high iron hemoglobin, also known as positive iron hemoglobin.with iron-containing hemoglobin (hemosiderin): formed by macrophages swallowing red blood cells, is actually an ferrite particle, brownish-yellow under the light mirror, and the iron ions containing iron hetethetein are Fe3 plus. the hemoglobin evolution of hematoma in the brain afterbrain haemorrhage is shown in Figure 1.The evolution of hemoglobin in hematoma and the evolution of hematocytinine in the ▎ of red blood cell integrity after brain haemorrhage, as shown in Figure 2.note that the integrity of the red blood cell membrane will affect the T2 signal on the magnetic resonance.although the hematoma contains the same substance, but after the dissolution of red blood cell rupture, hematoma into low-protein hematoma fluid, T2 can be from the previous low signal to a high signal, which helps us better understand the evolution of the subacute period of cerebral hemorrhage.Figure 2 The pathological evolution of hematoma after cerebral hemorrhage is divided into ultra-acute, acute, subacute and chronic periods in different periods of cerebral hemorrhage, and the time limits of each period are not yet uniform.▎ hyper-acute period: 6 hours to 24 hours blood just from the artery, red blood cells are complete, containing oxygenated hemoglobin, the most "original."blood that has not been coagulated during the hyperacute period shows the long T1 T2 characteristics of the blood in the MRI, i.e. the T1WI show a slightly lower signal and a high signal on T2WI. Hematoma surrounding edema can occur after 3 hours of the hyperacute period. Figure 3 Mr. ▎ acute period of cerebral hemorrhage hyper-acute period: 7 to 24 hours to 2 to 3 days acute period red blood cell cell membrane remained intact, oxygen-based hemoglobin released in the cell oxygen into deoxygenator hemoglobin. this period, the signal change on T1WI is not obvious, and the signal is shown as low on T2WI. the edema around the hematoma is shown on the MRI as a T1WI low signal and a higher T2WI signal. Figure 4 Diagrams and MRI images of mrI manifestations in the acute period of cerebral hemorrhage. (the diagram shows only the relative grayscale of the signal and does not represent true grayscale.) MRI imaging from Professor Tang Wei Lecture PPT) ▎ subacute period: 3 days to 2 weeks to 3 days to 3 weeks subacute hemoglobin evolution process by deoxygenated hemoglobin into high iron hemoglobin (positive iron hemoglobin), this evolution is carried out from the peripheral hematoma hematoma center site. the evolution of the subacute period red blood cells is the gradual rupture of red blood cells, which is also carried out from the peripheral hematoma to the central site of the hematoma. the change of deoxygenated hemoglobin and the rupture of red blood cells can overlap. when the red blood cell membrane is complete, high-iron hemoglobin because it is a paramagnetic substance, in mrI as a high signal t1, T2 low signal, but when the red blood cell dissolves rupture, as mentioned earlier, high-iron hemoglobin frees out, hematoma is low protein hematoma, at this time MRI is shown as a high signal of T1, T2 high signal. Figure 5 Acute early MRI performance of cerebral hemorrhage subacute (pictured from the reference s1) at the late subacute stage, or subacute "maturation", the red blood cells at the hematoma site are dissolved, deoxygenated hemoglobin becomes high-iron hemoglobin, MRI is shown as a high T1 signal, T2 low signal. subacute period, edema around hematoma is still present. Figure 6 The acute late-stage MRI performance of the cerebral hemorrhage subacute (the schematic shows only the relative grayscale of the signal and does not represent true grayscale). ) ▎ chronic period: Early stage OF the chronic period after 2 or 3 weeks is similar to subacute late stage. After , hemoglobin in the hematoma was eventually swallowed, decomposed, and removed, leaving behind a large amount of iron-containing hemoglobin. hematoma is gradually absorbed or liquefaction, part of the formation of the cystic cavity, the surrounding can appear significant iron-containing hemoglobin deposition. therefore, the T1WI is shown as a low signal, t2WI is shown as a high signal in the cystic cavity or liquefaction stove, and a low signal ring containing iron hemoglobin can appear around. chronic edema subsides. Figure 7 The acute stage OF BRAIN haemorrhage MRI shows schematics and MRI images. (the diagram shows only the relative grayscale of the signal and does not represent true grayscale.) MRI image from the reference s1) need to note that the evolution of cerebral hemorrhage is a continuous process, in the subacute late period, the hematoma surrounding high-iron hemoglobin is swallowed by macrophages, forming iron-containing hemoglobin deposits, as surrounding the hematoma T1, T2 low signal ring, at this time, subacute late and early chronic period actually have similar manifestations, less easy to distinguish. summary of both cerebral edema and no iron-containing hemoglobin ring signal manifestations of hematoma in the hyperacute stage, and in the ultra-acute period in the early; the evolution of cerebral hemorrhage is a complex process, according to the size of the patient's bleeding volume, the patient's age, local blood supply is good or bad, cerebral hemorrhage absorption and stage time is not the same, so clinicians need to dynamically assess the patient's disease process, for magnetic resonance performance to give a reasonable interpretation. the above contentaccording to Dalian University affiliated Xinhua Hospital neurology professor Tang Wei lecture "cerebrovascular disease MRI reading tips" finishing, more brain hemorrhage MRI reading exercises and explanations, welcome to visit the doctor station. References: Saei, Zhang Xuelin. Medical Imaging Diagnostics. Beijing: People's Health Press (3rd edition) This article review expert Professor Yan Liangyu, a part-time editor-in-chief of neurology in the medical field, Ph.D., graduated from the University of Hong Kong School of Medicine, graduated from Harvard Medical School, is currently the Director of Neurology, Director of the Shenzhen People's Hospital, Deputy Director; as the host of the National Natural Science Foundation of China, the evaluation expert, the youth member of the Chinese Stroke Society, the youth committee member of the Chinese Society of Preventive Medicine's stroke prevention and control professional committee, the deputy chairman of the branch of the Stroke Prevention and Control Professional Committee of the Guangdong Provincial Stroke Society, the vice chairman of the professional committee of cerebrovascular disease prevention and health promotion of the Guangdong Provincial Health Management Society; the member of the Guangdong Provincial Society of Physicians' Neurology Credit Stakes; HH Source: The Medical Neurology Channel !-- End of Content Presentation -- !-- To Determine Whether the Login Ends.