Summary
Four patients with cerebral hemorrhage were examined serially from the acute to chronic phase by1H magnetic resonance imaging (MRI),23Na MRI and computed tomography (CT). At 1–2 days after bleeding, the23Na image revealed no visible signal change in the area of hemorrhage, although CT and1H images clearly demonstrated the existence of a hematoma in the thalamus or putamen. At 4–7 days after the hemorrhage, the23Na images began to exhibit a small increase in signal intensity at the hematoma site, while at 2–3 weeks, a marked increase in23Na signal intensity was observed. These findings suggest that the hematoma consisted mainly of a corpuscular component, with a low Na+ concentration, with little serum component. Lack of signal from the corpuscular component on the23Na image was confirmed by an in vitro study. In the late acute phase, Na+ accumulation may occur in the corpuscular component due to failure of the Na+ pump. The intracellular23Na appears to be totally visible to MRI, resulting in an increase in signal intensity. In the subacute or chronic phase, the corpuscular component may be destroyed, leaving fluid in its place. A high Na+ concentration in this fluid may give markedly increased23Na signal intensity on MRI.23Na MRI appears to provide important information for understanding the evoluation of cerebral hemorrhage and for estimating the viability of cells, although its value for diagnosis may not be great.
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References
Hilal SK, Maudsley AA, Simon HE, Perman WH, Bonn J, Mawad ME, Silver AJ, Ganti SR, Sane P, Chein IC (1983) In vivo NMR imaging of tissue sodium in the cat before and after acute cerebral stroke. AJNR 4: 245–249
Hilal SK, Maudsley AA, Ra JB, Simon HE, Roschman P, Wittekoek S, Cho ZH, Mun SK (1985) In vivo NMR imaging of sodium-23 in the human head. J Comput Assist Tomogr 9: 1–7
Perman WH, Turski PA, Houston LW, Glover GH, Hayes CE (1986) Methodology of in vivo human sodium MR imaging at 1.5 T. Radiology 160: 811–820
Turski PA, Perman WH, Hald JK, Houston LW, Strother CM, Sackett JF (1986) Clinical and experimental vasogenic edema: in vivo sodium MR imaging. Work in progress. Radiology 160: 821–825
Winkler SS, Thomasson DM, Sherwood K, Sherwood K, Perman WH (1989) Regional T2 and sodium concentration estimates in the normal human brain by sodium-23 MR imaging at 1.5 T. J Comput Assist Tomogr 13: 561–566
Grood W, Klose U (1988) Sodium MR imaging of the brain: initial clinical results. Neuroradiology 30: 399–407
Turski PA, Perman WH, Houston L, Winkler SS (1988) Clinical and experimental sodium magnetic resonance imaging. Radiol Clin North Am 26: 861–871
Pike MM, Fossel ET, Smith TW, Springer CS (1984) High resolution23Na-NMR studies of human erythrocytes: use of aqueous shift reagents. Am J Physiol 246: C528-C536
Pettergrew JW, Woessner DE, Minshew J, Glonek T (1984) Sodium-23 NMR analysis of human whole blood, erythrocytes and plasma: chemical shift, spin relaxation, and intracellular sodium concentrations studies. J Magn Reson 57: 185–196
Boulanger Y, Vinay P, Desroches M (1985) Measurement of a wide range of intracellular sodium concentrations in erythrocytes by23Na nuclear magnetic resonance. Biophys J 47: 553–561
Gomori JM, Grossman RI, Goldberg HI, Zimmerman RA, Bilaniuk LT (1985) Intracerebral hematoma: imaging by high field MRI. Radiology 157: 87–93
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Shimizu, T., Naritomi, H., Kuriyama, Y. et al. Sequential changes of sodium magnetic resonance images after cerebral hemorrhage. Neuroradiology 34, 301–304 (1992). https://doi.org/10.1007/BF00588186
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DOI: https://doi.org/10.1007/BF00588186