Fluid Attenuated Inversion-Recovery Magnetic Resonance Imaging of Acute Subarachnoid Hemorrhage: Comparison with Non-Contrast-Enhanced Computed Tomography

ABSTRACT

OBJECTIVE: Our aim is to evaluate the usefulness of fluid-attenuated inversion recovery(FLAIR) magnetic resonance(MR) imaging for detection of acute subarachnoid hemorrhage(SAH) compared with non-contrast-enhanced computed tomography(CT). METHODS: We compared FLAIR MR images with non-contrast-enhanced CT scans in 34 patients with acute SAH. Findings of SAH on CT and MR images were graded as 0(absence), 1(suspicious), and 2(definite) in the cerebral sulci, sylvian fissures, basal cisterns, and cisterns of the posterior cranial fossa. We also compared FLAIR MR images of 34 patients with those of 35 normal subjects, and then the sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of acute SAH were calculated. RESULTS: FLAIR MR image was superior to CT in detecting SAH in the cranial fossa posterior(1.41+/-0.74 vs. 0.78+/-0.80, p<0.05) and cortical sulci(1.11+/-0.80 vs. 0.70+/-0.83 p<0.05). There was no significant difference between FLAIR MR image and CT in detecting SAH in the basal cisterns and sylvian fissures. The sensitivity, specificity, and diagnostic accuracy of FLAIR MR image for detection of SAH were 100% in all. CONCLUSION: FLAIR MR image is useful in detecting acute SAH, especially in patients with SAH in the posterior cranial fossa and cerebral sulci.