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Low diagnostic yield in follow-up MR imaging in patients with spontaneous intracerebral hemorrhage with a negative initial MRI

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Purpose

Follow-up MRI/MRA is historically obtained as outpatient when patients with a spontaneous intracerebral hemorrhage (ICH) have an initial MRI/MRA that is negative for an underlying structural lesion. However, the utility of repeating MR imaging in a delayed fashion remains uncertain.

Methods

We retrospectively reviewed 396 patients with spontaneous ICH admitted at our institution between 2015 and 2017 and selected those whose initial MRI/MRA was negative for an underlying structural lesion and those who underwent follow-up MR imaging in a delayed fashion.

Results

A total of 113 patients met the study criteria. The average age of those with negative follow-up MRI/MRA was 65.0 ± 12.6 (IQR: 55.0–74.0) years old. None of the 113 patients with a negative inpatient MRI/MRA had an underlying structural lesion on follow-up MRI/MRA (0%, 95% CI 0.0–0.032, p < 0.001). The mean time of the follow-up imaging from the initial study was 105.7 days (median: 62 days; IQR: 42.5–100.5). Of the 113, 83 (73.5%) underwent follow-up MRI with and without gadolinium, while 30 (26.5%) patients did not receive gadolinium.

Conclusion

Delayed follow-up MRI in patients with a negative initial MRI/MRA for workup of spontaneous ICH was not diagnostic in any of the patients included in the study. Our study suggests that a routine follow-up MRI for this patient population is not necessary.

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Neurosurgery, Jefferson Hospital for Neuroscience, Thomas Jefferson University, Philadelphia, PA, USA

    Nikolaos Mouchtouris, Fadi Al Saiegh, Nohra Chalouhi, Ahmad Sweid, Reid Gooch, Stavropoula Tjoumakaris, Robert Rosenwasser & Pascal Jabbour

  2. Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA

    Emily J. Papai, Daniella Wong, Julie Kim, Austin Saline & David Nauheim

  3. Division of Neurovascular Surgery and Endovascular Neurosurgery, Thomas Jefferson University Hospital, 901 Walnut street 3rd Floor, Philadelphia, PA, 19107, USA

    Pascal Jabbour

Authors
  1. Nikolaos Mouchtouris
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  2. Fadi Al Saiegh
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  3. Nohra Chalouhi
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  4. Ahmad Sweid
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  5. Emily J. Papai
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  6. Daniella Wong
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  7. Julie Kim
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  8. Austin Saline
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  9. David Nauheim
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  10. Reid Gooch
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  11. Stavropoula Tjoumakaris
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  12. Robert Rosenwasser
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  13. Pascal Jabbour
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Corresponding author

Correspondence to Pascal Jabbour.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

No procedures were performed in this study. This study was conducted in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was not required as per the study protocol that was reviewed and approved by the Thomas Jefferson University Institutional Review Board.

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Mouchtouris, N., Saiegh, F.A., Chalouhi, N. et al. Low diagnostic yield in follow-up MR imaging in patients with spontaneous intracerebral hemorrhage with a negative initial MRI. Neuroradiology 63, 1009–1012 (2021). https://doi.org/10.1007/s00234-020-02570-1

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  • DOI: https://doi.org/10.1007/s00234-020-02570-1

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