ICH patients, age 18–85 years, with brain parenchymal hemorrhage, no previous ICH, and no evidence of physiological calcification on noncontrast CT of the head were included in the study. One control and two human subjects who met the inclusion criteria for the study were scanned with the same MRI protocol utilized on the phantom. The two human subjects had spontaneous basal ganglia hemorrhage and were scanned on day 7 of their hemorrhage. In the control human brain, MRI regions of interest (ROIs) were drawn in the basal ganglia region on both hemispheres. Calculations were performed on R2* maps generated from the MRI sequences (Fig. 2a). In the two human subjects, regions of interest were drawn on the periphery of the hematoma in the left basal ganglia (Fig. 2b, c). Region of interest measurements were also performed on the contralateral normal hemisphere in an identical anatomical location.

Our experiment demonstrates proof of principle of MRI being able to detect a 4 times increase in tissue iron levels in the periphery of the hematoma in comparison to baseline. The initial translation from bench to bedside of iron-chelating therapy with deferoxamine being investigated by a phase II trial holds promise. Our hypothesis, once validated in a larger study, can provide a surrogate marker of severity of neurotoxicity following an ICH. Moreover, an MRI-based brain tissue iron quantification may provide a more objective way of monitoring therapy with iron chelates. Furthermore, the correlation of tissue iron quantification with functional outcome following an ICH needs to be studied in a large-scale prospective analysis involving human subjects.