MRI Diagnosis And Differential Diagnosis Of Hemorrhagic Intracerebral Astrocytoma

Objective To study the MRI features of bleeding intracerebral astrocytomas and the value of MRI distinguishing bleeding astrocytomas from the non-neoplastic hematomas .Material and Methods 37 cases intracerebral hemorrhage were collected, 15 cases of hemorrhagic intracerebral astrocytomas with pathologic confirmation were investigated. 22 cases of non-neoplastic hemorrhage confirmed by pathology , DSA or follow up datas were investigated. All cases underwent MR imaging, After the administration of 0.1 mmol/kg Gd-DTPA, contrast-enhanced T1-weighted images were obtained in all astrocytomas and part of the non-neoplastic hemorrhage cases.Results â‘  Focal hemorrhage types of hemorrhagic astrocytomas, Hemorrhage were focal or nodular hyperintense on T1WI, T2WI were hyperintense mainly, Arounding the hemorrhage were tumors presented as hypointense on T1WI, and hyperintense on T2WI, and enhanced in varying degrees and shapes after intravenous Gd-DTPA enhancement. (2) To nordular hemorrhage type, hemorrhage was round or roundish, All of the 22 cases of non-neoplastic hematomas, 12 cases were elliptoid or irregular, account for 54.5%; â‘¡ 10 cases of non-neoplastic hematomas were high signal intensity and homogenety, 2 cases showed up circuitous flow void signal. (4) All hemorrhagic astrocytomas showed enhancement, To non-neoplastic hematomas, 2 cases presented non- enhancement in all of 10 caces accepted Gd-DTPA; To the nodular hemorrhage type, non-hemorrhage section show non-homogeneous enhancement and nordular enhancement were shown in some cases. To non-neoplastic hematomas, enhancement form were according with hemorrhagic shape.Conclusion It is reliable using MRI to diagnose focal hemorrhage type of astrocytomas; Non-homogeneous enhancement of non-hemorrhage section and nodular enhancement clew hemorrhagic astrocytomas. Non-roundish hemorrhagic form, high signal intensity and homogeneity, flow void signal, non-enhancement, and enhancement form according with hemorrhagic shape suggest non-neoplastic hematomas. In conclusion, it is helpful using MRI combining clinic datas and disease history to differentiate hemorrhagic intracerebral astrocytomas from non-neoplastic hematomas .