The Gre-t2 * Wi Sequence Analysis Of Spontaneous Intracerebral Hemorrhage Iron Lesion Evolution Process Of Animal Studies And Clinical Cases Were Followed Up

Background and Objective:Intracerebral hemorrhage(ICH)has become the main threaten to the middle-aged and elderly people with its considerable morbidity and mortality, and brought severe burden to our country and society. The growth in the living standard needs us to do better in the therapy of ICH.Most previous treatment to ICH was about removing the space-occupying lesion effect, but no effective solution to secondary nerve injury. Recent studies have demonstrated the deposition of iron in the brain is proposed to play a role in the potential toxicity and poor neurological outcome related to ICH.CT was considered as the gold standard of ICH,but more and more new MRI sequences have occurred with technology development.The use of these MRI sequences is potentially important for the study of interventions aimed at reducing brain tissue iron load.We hypothesize that the MRI signal changes seen in gradient echo sequences(GRE,or T2*)correspond closely to tissue iron deposition.In this research,we use T2* to follow up the succession of the ICH lesion.Materials and methods:Animal experiment20 adult SD rats,weighing 350-400g,were randomly divided into control and experimental groups.Experimental group A were injected with 10ul of auto-blood,Group B was injected with 50ul of auto-blood,Group C was injected with 100ul of auto-blood and the control group eight rats were divided into two groups,one group only inserting needle without injection of blood (n=4) and the other only drilling without inserting needle (n=4).We used the Horizontal Bore 7.0 Tesla magnetic resonance to scan the regions around the injection needle on day 1,day 3,day 7,day 14,and day 30 of Group A,B.T2 weighted imaging (T2W1),gradient echo T2* weighted imaging (GRE T2* WI) secquence were performed.The control group was observed on day 1.Group C only went through the scan on the first day, and then Perl's staining were performed.We use image analysis software image J to analyze the images.Clinical cases following up We collected 10 cases of super-acute and acute spontaneous intracerebral hemorrhage from Shanghai Huashan Hospital Nanhui branch from September 2009 to February 2010.After admission,those cases were confirmed as ICH by brain CT.Repeated MRI scan (T1,T2,T2*,DWI)were performed of the patients on the first day,7th days and 14th days after admission.Then we use image analysis software image J to analyze the images.Statistical analysis(1)We use t test to analyze the hematoma volume measured by T2 and T2* MRI sequence image of the animal experiment group with statistical package SPSS (version 11.5).(2) We use t test to analyze the hematoma volume measured by T2,T2* MRI sequence image and DWI and T2* of clinical cases with statistical package SPSS (version 11.5).Results:Animal experiments group A's hematoma volume measured by T2,T2* MRI sequence image have statistically significant differences (all P<0.05) except day1.Group B's hematoma volume measured by T2,T2* MRI sequence image have statistically significant differences (all P<0.05).We compared C group(100ul auto-blood injection group) T2* WI with Perl's staining slices we could see the Perls'staining pattern in these animals demonstrated that the region of T2* change correlates closely with ferric iron deposition.In the clinical cases,we saw GRE-T2* WI sequence could clearly show the intracerebral hematoma size and contour. T2WI sequences could also show the hematoma area,but not clearly enough.Those cases's hematoma volume measured by T2,T2* MRI sequence image have statistically significant differences (all P<0.05)Conclusion:(1)GRE T2* WI has the same sensitivity as CT scan in the diagnosis of hyperacute and acute intracerebral hematoma.With the help of conventional MRI scans (T1WI.T2WI and DWI),we can make definite diagnosis of ICH. (2) GRE T2*WI sequence has its advantages compared to other serial scans because of high-sensitivity to paramagnetic material:clear lesion border, and the high sensitivity of the small lesions. It can be used as the intracerebral hemorrhage lesion follow-up tool.