Magnetic resonance imaging with gadolinium DTPA enhancement in patients with acute head injury

Citation
Y. Takanashi et al., Magnetic resonance imaging with gadolinium DTPA enhancement in patients with acute head injury, J NEUROTRAU, 17(4), 2000, pp. 359-365
Citations number
8
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Neurosciences & Behavoir
Journal title
JOURNAL OF NEUROTRAUMA
ISSN journal
0897-7151 → ACNP
Volume
17
Issue
4
Year of publication
2000
Pages
359 - 365
Database
ISI
SICI code
0897-7151(200004)17:4<359:MRIWGD>2.0.ZU;2-G
Abstract
Gadolinium-enhanced magnetic resonance (MR) imaging in patients with acute head injury was conducted to study if contrast extravasation was associated with development of hemorrhagic lesions. A series of 60 head-injured patie nts were admitted to our emergency unit. Computerized tomography (CT) scans and skull x-ray films were taken as rapidly as possible after hospitalizat ion. Injury severity on admission was evaluated using the Glasgow Coma Scal e (GCS) score, motor score, and pupillary examination, while overall outcom e was assessed with the Glasgow Outcome Scale (GOS) 3 months after injury. Of all patients admitted, MR imaging with gadolinium enhancement was perfor med in 18 patients who were at high risk of developing hemorrhagic lesion w ithin 6 h after injury. In these patients we investigated whether contrast extravasation was associated with development of hemorrhagic lesions. All 1 8 patients presented abnormal findings on their admission CT scans. Admissi on GCS score in those patients who underwent MR imaging with gadolinium enh ancement was 13 or more in 12 patients, 9-12 in four patients, and 8 or les s in two patients. Fourteen of 18 patients showed contrast extravasation, c orresponding with an evolution of lesion size. Nine of 14 patients who demo nstrated extravasation of the contrast medium required surgical treatment. The results of the current study suggest that extravasation of contrast med ium indicates a continuance of posttraumatic bleeding. Thus, MR imaging wit h gadolinium enhancement in acutely head-injured patients may constitute a reasonable strategy for predicting the development of hemorrhagic lesions.