Low Diagnostic Yield in Follow-up MR Imaging in Patients with Spontaneous Intracerebral Hemorrhage with a Negative Initial MRI. (16th November 2020)

• Record Type: Journal Article
• Authors: Mouchtouris, Nikolaos; Saiegh, Fadi Al; Chalouhi, Nohra El; Wong, Daniella; Kim, Julie; Nauheim, David; Khanna, Omaditya; Gooch, M. Reid; Tjoumakaris, Stavropoula I; Rosenwasser, Robert H; Jabbour, Pascal
• Is Part Of: Neurosurgery. Volume 67(2010)Supplement 1
• Publication Date: 2020-11-16
• Subjects: Nervous system -- Surgery -- Periodicals; 617.48005
• DOI: 10.1093/neuros/nyaa447_236
• Languages: English
• ISSNs: 0148-396X

Abstract

Abstract: INTRODUCTION: 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, non-traumatic ICH admitted at our institution between 2015–2017 whose initial MRI/MRA was negative for an underlying structural lesion. Of them, 113 had a follow-up MR imaging in a delayed fashion and met the inclusion criteria for our study. RESULTS: A total of 113 patients met the study criteria. The average age of those with negative follow-up MRI/MRA was 65.3 ± 15.7 (range: 17–96) 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 < . 001). The mean time of the follow-up imaging from the initial study was 105.7 ± 129.1 days (median: 62 days). 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.