RESUMO
We compared contrast enhancement on T1-weighted MRI of acute cerebral infarcts after conventional bolus administration and continuous infusion of gadolinium. We examined 12 patients with a history of acute stroke with contrast-enhanced MRI once a week for a 1 month. Only ischaemic lesions were investigated after cerebral haemorrhage had been excluded by CT. Each MRI study included T2- and proton density-weighted sequences for determination of the size and site of the infarct, immediate postinjection T1-weighted imaging after bolus administration of 0.1 mmol/kg gadolinium-DPTA and delayed T1-weighted imaging after additional continuous infusion of 0.1 mmol/kg over 2 h. A total of 42 MRI studies was performed. In the first week after the onset of stroke, most infarcts (8 of 10) did not enhance after bolus administration, whereas all showed distinct contrast enhancement after the infusion. In the following weeks all but two infarcts showed contrast enhancement after bolus administration; after continuous infusion contrast enhancement could be seen in all cases. While contrast enhancement after bolus administration showed the typical gyriform pattern, enhanced areas were more extensive after the infusion and usually covered the entire infarcted area shown on T2- and proton density-weighted images. We presume that the disturbed blood-brain barrier in ischaemic areas favours delivery of contrast medium to the infarcted tissue if it is offered continuously so that a steady state can develop.
Assuntos
Infarto Cerebral/diagnóstico , Meios de Contraste/administração & dosagem , Gadolínio DTPA , Aumento da Imagem/métodos , Imageamento por Ressonância Magnética/métodos , Doença Aguda , Idoso , Idoso de 80 Anos ou mais , Barreira Hematoencefálica , Isquemia Encefálica/diagnóstico , Hemorragia Cerebral/diagnóstico por imagem , Transtornos Cerebrovasculares/diagnóstico , Feminino , Seguimentos , Gadolínio DTPA/administração & dosagem , Humanos , Processamento de Imagem Assistida por Computador/métodos , Infusões Intravenosas , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios XRESUMO
We report a case of putaminal haemorrhage from a venous cerebral angioma following thrombosis in a draining vein. The patient complained of numbness of the right side, followed by headache and aphasia. CT demonstrated an intracerebral haemorrhage due to thrombotic occlusion of a draining vein of the venous angioma. Carotid angiography showed the venous angioma. MRI studies confirmed the diagnosis and demonstrated recanalisation of the draining vein following therapy with phenprocoumon.