Comparison between Gradient-Echo Images and b0 Images Obtained from Diffusion-Weighted Echo-Planar Sequences in Detection of Blood Products in Cerebral Hemorrhagic Vascular Accidents

Purpose: Our aim was to evaluate the clinical utility of b0EPI images obtained from diffusion sequence versus GRE images for the detection of the intra-axial hemorrhagic lesions, especially acute intracerebral bleeds thereby shorten the scan time particularly in the critical acute cases of stroke thus altering the plan of treatment. Material and Methods: A retrospective study over a year duration with patients’ admitted to the emergency department with clinical presentation stroke who were subjected to MR examination with DWI and GRE images to evaluate the most sensitive sequence for depiction of blood in acute vascular insults (intra-axial hematoma, hemorrhagic venous infarct and hemorrhagic transformation of cerebral infarct). Results: Forty-six patients were included in this studywith a variety of pathogeneses in various locations. All of these lesions were hemorrhagic (hypointense) on the GRE sequences, whereas 40 (87%) were characterized as hemorrhagic on b0EPI images, and 6 (13%) were not detected. The overall difference in hemorrhage conspicuity/diagnostic certainty between GRE and b0EPI sequences was statistically significant (p 0.05). Conclusion: GRE is superior to B0 used in detection of blood products in stroke patients.