Hyperdensity of recent hemorrhage at body computed tomography: incidence and morphologic variation.

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Abstract
Body computed tomography (CT) scans were reviewed in 73 patients with hematomas of recent onset. The incidence, extent and morphologic variation of regions of hyperdensity on precontrast scans were assessed. Hyperdensity was also sought in the scans of 80 control subjects with a mass due to neoplasm or hematomas, 55 (75%) exhibited regions of localized or diffuse hyperdensity. Only 1 of the 80 (1.25%) control lesions showed relative hyperdensity that could not be explained by obvious calcification, bone fragments or diminished density of the organ of origin. Predominant hyperdensity throughout the lesion was present in 35 (48%) of the hematomas and in 16 (22%) was homogenous in texture. Other patterns of hyperdensity included linear shadows, hyperdense filling defects surrounded by fluid, dependent position of hyperdense fragments, and fluid levels with dependent hyperdensity. Hyperdensity at CT was due to the high Hb content of retracted clot or sedimented blood. The various patterns seen can be related to sequential changes occurring in blood following hemorrhage. Relative hyperdensity and its variations seen on precontrast scans are useful diagnostic signs of recent hemorrhage.