MRI in diagnosis of SAH - evaluating a non-invasive alternative to LP
Research type
Research Study
Full title
Combined SWI and FLAIR imaging in the diagnosis of spontaneous subarachnoid haemorrhage: utility as a non-invasive alternative to lumbar puncture
IRAS ID
127845
Contact name
Joseph A Lansley
Contact email
Sponsor organisation
Imperial College Healthcare NHS Trust
Duration of Study in the UK
1 years, 0 months, 1 days
Research summary
Bleeding into the fluid lining the brain is known as subarachnoid haemorrhage (SAH). This can be caused by a ruptured abnormal blood vessel (aneurysm) which, if untreated, may be fatal. In order to diagnose and treat this condition, it is necessary to recognise the presence of blood around the brain. CT scans are usually used to look for blood but can appear normal even when bleeding has occurred. Therefore a further test is recommended if the initial scan is normal. The second test is a lumbar puncture (LP) which involves taking a sample of spinal fluid to see if there are any blood products in it. LP is invasive, can be uncomfortable for the patient, may necessitate expensive and inconvenient hospital admission, and can have complications. Furthermore, blood introduced during the LP procedure may cause a false positive result and lead to misdiagnosis.
Use of a non-invasive imaging test in place of LP would avoid the associated complications and costs of admission and could prevent the inappropriate treatment of aneurysms which have not bled.
Modern MRI techniques have improved sensitivity to blood and blood products and may provide a suitable alternative to LP. Before testing this it is necessary to establish whether or not MRI scans are better than CT scans at detecting blood around the brain in these patients.
The primary aim of this study is to evaluate detection of spontaneous SAH using special MR sequences known as - Susceptibility Weighted Imaging (SWI), Fluid Attenuated Inversion Recovery (FLAIR) and Double Inversion Recovery (DIR). The purpose of this study is to establish the utility of these special MR imaging techniques as a non-invasive strategy for diagnosis of SAH.
REC name
HSC REC A
REC reference
14/NI/0017
Date of REC Opinion
12 Feb 2014
REC opinion
Favourable Opinion