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Master Thesis

Évaluation de l’exactitude diagnostique de l’IRM encéphalique sans injection pour l’identification des hématomes intraparenchymateux primitifs

Abstract : Purpose : to compare the diagnostic value of non-enhanced brain magnetic resonance imaging (MRI) with that of a complete brain MRI performed with an injection of gadolinium-based contrast agent (GBCA) for the identification of typical primary intracerebral hemorrhages (ICHs) caused by hypertension and cerebral amyloid angiopathy. Materials and Methods : the local institutional ethics committee approved this prospective study, and all patients provided informed consent. One hundred sixty-three consecutive patients with a spontaneous ICH from March 2015 to March 2016 were included. Two radiologists independently analyzed the MRI images in a two-step procedure that included a diagnostic algorithm in which an intermediate conclusion was based on non-enhanced sequences and a final conclusion included all sequences. The sensitivity, specificity, and accuracy of each analysis were calculated, and the accuracy was compared using an adjusted McNemar test. Results : the sensitivity, specificity and accuracy of the non-enhanced brain MRI were respectively 43%, 96.8% and 66.2% for reader 1, and 49.4%, 95.3% and 68.8% for reader 2. The sensitivity, specificity and accuracy of the complete-injected brain MRI were 36.4%, 98.2% and 63.3% for reader 1, and 39.7%, 100% and 66.4% for reader 2. The difference in accuracy was not significant (p=0,7893). Conclusion : the diagnostic value of the non-enhanced brain MRI scans was similar to that of the complete brain MRI scans with GBCA injections for the identification of typical primary ICH. Thus, the injection of GBCAs could be avoided in patients with primary ICH identified by non-enhanced sequences.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01515518
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Submitted on : Thursday, April 27, 2017 - 4:00:17 PM
Last modification on : Wednesday, August 23, 2017 - 4:41:50 PM
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Nina Harbonnier Escalier. Évaluation de l’exactitude diagnostique de l’IRM encéphalique sans injection pour l’identification des hématomes intraparenchymateux primitifs. Médecine humaine et pathologie. 2017. ⟨dumas-01515518⟩

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