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Master Thesis

Performance diagnostique de l'IRM dans les transformations hémorragiques post accidents ischémiques cérébraux (PITHA)

Abstract : Introduction: CT is the first-line test to detect hemorrhagic transformation (HT) after acute ischemic stroke (AIS) and influence their management. MRI is taking an increasing place in this indication. We have therefore studied the diagnostic performance of MRI and its concordance with CT. Patients and Methods: Our retrospective monocentric study conducted in the Neuroradiology Department of Rothschild Foundation Hospital consecutively included all patients followed by MRI and CT scan of the brain spaced less than 36 hours apart less than 4 days after a stroke between June 2017 and July 2019. A blind reading of the clinic's imaging data allowed the classification of MRI signal abnormalities according to a newly created SWI classification and CT hyperdensities according to the ECASS classification. Results: 94 patients were included of which 53.2% were male with a median NIHSS of 15.5. The median age was 76 years. The mean time between MRI and CT scan was 8 hours. 63 patients (67%) had visible TH in SWI versus 29 (31%) in CT. The SWI sequence had high sensitivity (97%) and negative predictive value (97%) but low specificity (46%). After categorization of TH according to the classification created, the agreement between MRI and CT for detection of PH2 TH is moderate (kappa = 0.54) with a sensitivity of 80% and specificity of 94%. Conclusion: MRI detects twice as much TH as CT but with poor specificity. The use of a classification dedicated to MRI allows to increase its specificity and its concordance with CT.
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Master Thesis
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Submitted on : Monday, April 19, 2021 - 2:21:44 PM
Last modification on : Tuesday, October 19, 2021 - 11:34:51 PM
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  • HAL Id : dumas-03201986, version 1


Grégoire Braux. Performance diagnostique de l'IRM dans les transformations hémorragiques post accidents ischémiques cérébraux (PITHA). Médecine humaine et pathologie. 2020. ⟨dumas-03201986⟩



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