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<meta name="DC.Description" content="Thirty patients with intracranial tumors containing hemorrhage of varying stages were examined with high-field-strength MR imaging and CT to determine what differences might exist between hemorrhagic tumor and pure hemorrhage. Pathology was obtained in the six patients with primary tumors and in 14 of the 24 patients with metastases. Similar to evolving intraparenchymal hematomas, hemorrhagic neoplasms undergo changes in their appearance that can be categorized into three distinct intensity patterns, or stages. Stage 1 is characterized as iso- or hypointensity on short TR sequences and as hypointensity on long TR sequences; stage 2 as developing hyperintensity on both short and long TR sequences, without evidence of a well-defined black rim; and stage 3 as a hyperintense lesion with a well-defined black rim on long TR sequences. An additional mixed-intensity pattern was identified, which contained areas corresponding to more than one stage. In all of the cases exhibiting this pattern, pathology confirmed that the appearance was due to recurrent bleeding. We found several characteristics on MR that, when present, suggest an underlying neoplasm. These include delay in evolution between stages, central or eccentric hyperintensity in stage 2, and a mixed-intensity pattern. In addition, the presence of a hemosiderin rim does not exclude an underlying neoplasm.

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<meta name="twitter:description" content="Thirty patients with intracranial tumors containing hemorrhage of varying stages were examined with high-field-strength MR imaging and CT to determine what differences might exist between hemorrhagic tumor and pure hemorrhage. Pathology was obtained in the six patients with primary tumors and in 14 of the 24 patients with metastases. Similar to evolving intraparenchymal hematomas, hemorrhagic neoplasms undergo changes in their appearance that can be categorized into three distinct intensity patterns, or stages. Stage 1 is characterized as iso- or hypointensity on short TR sequences and as hypointensity on long TR sequences; stage 2 as developing hyperintensity on both short and long TR sequences, without evidence of a well-defined black rim; and stage 3 as a hyperintense lesion with a well-defined black rim on long TR sequences. An additional mixed-intensity pattern was identified, which contained areas corresponding to more than one stage. In all of the cases exhibiting this pattern, pathology confirmed that the appearance was due to recurrent bleeding. We found several characteristics on MR that, when present, suggest an underlying neoplasm. These include delay in evolution between stages, central or eccentric hyperintensity in stage 2, and a mixed-intensity pattern. In addition, the presence of a hemosiderin rim does not exclude an underlying neoplasm.

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      <h1 class="highwire-cite-title" id="page-title">MR Imaging of Hemorrhagic Intracranial Neoplasms</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Sylvie Destian</span>, <span class="highwire-citation-author" data-delta="1">Gordon Sze</span>, <span class="highwire-citation-author" data-delta="2">George Krol</span>, <span class="highwire-citation-author" data-delta="3">Robert D. Zimmerman</span> and <span class="highwire-citation-author" data-delta="4">Michael D. F. Deck</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">November 1988,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">9 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1115-1122; </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-13358--61249485516" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Sylvie Destian </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>1</span>Department of Radiology, Cornell University Medical Center and New York Hospital, 525 E. 68th St., New York, NY 10021</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Sylvie%2BDestian%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Destian%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3ASylvie%2BDestian%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Gordon Sze </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>2</span>Department of Medical Imaging, Memorial Sloan-Kettering Cancer Center, 1275 York Ave., New York, NY 10021. 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<p id="p-1">Thirty patients with intracranial tumors containing hemorrhage of varying stages were examined with high-field-strength MR imaging and CT to determine what differences might exist between hemorrhagic tumor and pure hemorrhage. Pathology was obtained in the six patients with primary tumors and in 14 of the 24 patients with metastases. Similar to evolving intraparenchymal hematomas, hemorrhagic neoplasms undergo changes in their appearance that can be categorized into three distinct intensity patterns, or stages. Stage 1 is characterized as iso- or hypointensity on short TR sequences and as hypointensity on long TR sequences; stage 2 as developing hyperintensity on both short and long TR sequences, without evidence of a well-defined black rim; and stage 3 as a hyperintense lesion with a well-defined black rim on long TR sequences. An additional mixed-intensity pattern was identified, which contained areas corresponding to more than one stage. In all of the cases exhibiting this pattern, pathology confirmed that the appearance was due to recurrent bleeding. We found several characteristics on MR that, when present, suggest an underlying neoplasm. These include delay in evolution between stages, central or eccentric hyperintensity in stage 2, and a mixed-intensity pattern. In addition, the presence of a hemosiderin rim does not exclude an underlying neoplasm.</p>
<p id="p-2">We found that the MR patterns that characterize hemorrhagic intracranial neoplasms should help to determine the cause of the hemorrhage.</p>
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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 9</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 6 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Nov 1988 </div></div>
      
      
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      <div class="highwire-cite-title">MR Imaging of Hemorrhagic Intracranial Neoplasms</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">Sylvie</span> <span class="nlm-surname">Destian</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">Gordon</span> <span class="nlm-surname">Sze</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">George</span> <span class="nlm-surname">Krol</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">Robert D.</span> <span class="nlm-surname">Zimmerman</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">Michael D. F.</span> <span class="nlm-surname">Deck</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Nov 1988, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">9 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(6) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1115-1122; </span></div>
  
  
  
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