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Sequential changes of sodium magnetic resonance images after cerebral hemorrhage

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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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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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Key words

  • 23Na MRI
  • 1H MRI
  • Cerebral hemorrhage