How to differentiate on CT ???

[halifax]

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So I had a patient admitted with acute onset of confusion and he underwent a CT which was read by radiologist as 6mm X 4mm intra cerebral hemorrhage. (he also said this is more likely than mineralization).

My question is how can you tell them apart on a CT - I know one way is by looking at the HU but is it possible to apply that even if its a small hemorrhage???

I'm no means a radiologist but to me it looked suspiciously like a calcification as the patient had calcification on the contra lateral side but a cut above this pathology.

All inputs will be greatly appreciated.

 

[Radiem]

That's hard to answer without seeing the pictures, and really, you should call the radiologist who read the study if you really want to know the thinking behind the call.

Things to look for: mass effect (though it may be subtle with small bleeds), surrounding edema. You didn't mention where the hemorrhage was located. Bilateral basal ganglia calcifications are seen pretty frequently, but they tend to be fairly symmetric. HU's could help since metal density calcs are going to be higher than clot, but that's prone to sampling error for small lesions.

The doc who read the study may have had other things that pointed him/her towards hemorrhage.