FLAIR Imaging in Patients with Low Grade Subarachnoid Hemorrhage during the Non-acute Phase

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  • クモ膜下出血軽症例における非急性期のFLAIR画像

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Fluid attenuated inversion recovery (FLAIR) imaging is capable of accurately diagnosing subarachnoid hemorrhage (SAH) not only during the acute phase, but also during the subacute and chronic phases. However, the findings of non-acute SAH on FLAIR imagings have not been described in detail. We evaluated six patients (all female, age range 57-82 years) who clinically demonstrated low grade SAH due to aneurysmal rupture. In this series, the first FLAIR imagings were obtained between 9 days and about one month after the ictus. Four characteristic findings were: 1) SAH could not be detected around the aneurysm or basal cistern, 2) the site of a ruptured aneurysm could not be predicted, 3) blood in an occipital horn of the lateral ventricle could not be distinguished as periventricular hyperintensity because the amount of SAH was slight, and 4) SAH in the cortical sulci was depicted as slightly or moderately high intensity of the broad regions while SAH in the sylvian fissure appeared as a higher intensity of the small regions. These findings indicate that FLAIR imaging is an effective means of detecting non-acute low grade SAH. Although the sensitivity is not as high as that during the acute period, it is still superior to CT. To detect non-acute SAH, it is necessary to pay attention to the extent of the signal change areas and the degree of high intensity, and to understand the limitations of FLAIR imaging.

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