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--- hemorrhage [2026/05/01 14:03] – scott
+++ hemorrhage [2026/05/01 14:41] (current) – [Case Examples] scott
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 ====Important Sequences for Identifying Hemorrhage====
+===T2* weighted Imaging===
+Strong T2* weighting is especially important for identifying the presence of hemorrhage of any size. The iron content of the blood will lead to dephasing and signal loss, know as 'blooming' artifact or susceptibility artifact.  Strong T2* weighting can only be achieved with a __Gradient Echo__ pulse sequence. Small hemorrhages may be impossible to see on other sequences and weightings.  There are many different options and sequences to achieve T2* weighting, but the most important ley parameter is that the TE is long; at least 15-20ms or higher. Below are some different gradient echo options, from most sensitive to least sensitive for detecting hemorrhage:
+  - SWAN (GE)/SWI (Siemens) - Susceptibility weighted imaging; very long TE's, 3D Gradient echo
+  - MERGE (GE)/MEDIC (Siemens) - Multi echo gradient echo; multiple TE's, 2D or 3D
+  - Standard GRE - Make sure it's not a fast or RF spoiled GRE and you can set the TE to about 20ms
+===T1 Weighted Imaging==
+While T2* weighted images are crucial for detecting hemorrhage, T1 weighted images are valuable as an adjunct in aging hemorrhage. As noted in the chart above, subacute hemorrhage has a characteristic T1 hyperintensity, best assessed with a T1w fast spin echo.
+====Case Examples====
+{{::hyperacutehematoma.png?600|}}
+{{:subacutehematoma.png?600|}}
+{{::microhemorrhageswan.png?600|}}
+{{::hemorrhagetumor.png?600|}}