Detection of Hemorrhagic Hypointense Foci in the Brain on Susceptibility-Weighted Imaging

Akter, Masuma; Hirai, Toshinori; Hiai, Yasuhiro; Kitajima, Mika; Komi, Masanori; Murakami, Ryuji; Fukuoka, Hirofumi; Sasao, Akira; Toya, Ryo; Haacke, E. Mark; Takahashi, Manabu; Hirano, Teruyuki; Kai, Yutaka; Morioka, Motohiro; Hamasaki, Kiyotoshi; Kuratsu, Jun Ichi; Yamashita, Yasuyuki

doi:10.1016/j.acra.2007.05.013

Cited by 81 publications

(49 citation statements)

References 20 publications

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“…[9][10][11][12][13]15 SWI may do the following: 1) detect hemorrhagic components within infarcted tissue with higher sensitivity than other MR imaging sequences or imaging modalities, 16 2) demonstrate hypointense signals in the veins draining hypoperfused areas and evaluate the ischemic penumbra by focusing on the venous drainage, [9][10][11][12] 3) show hyperintense signal in the veins draining regions of hyperperfusion or luxury perfusion indicating an increased risk of developing postischemic malignant edema, 13 4) detect acute occlusive arterial thromboemboli, 17,18 5) quantify microhemorrhages and predict hemorrhagic transformation before thrombolytic therapy is initiated, 19 and 6) detect early hemorrhagic complications after intra-arterial thrombolysis. 17 Currently, most studies focus on adults, and literature on the role of SWI in PAIS is scant, based mostly on case reports or small case series.…”

Section: Discussionmentioning

confidence: 99%

Susceptibility-Weighted Imaging in Pediatric Arterial Ischemic Stroke: A Valuable Alternative for the Noninvasive Evaluation of Altered Cerebral Hemodynamics

Polan

Poretti

Huisman

et al. 2014

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE: SWI provides information about blood oxygenation levels in intracranial vessels. Prior reports have shown that SWI focusing on venous drainage can provide noninvasive information about the degree of brain perfusion in pediatric arterial ischemic stroke. We aimed to evaluate the influence of the SWI venous signal pattern in predicting stroke evolution and the development of malignant edema in a large cohort of children with arterial ischemic stroke.

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Section: Discussionmentioning

confidence: 99%

Susceptibility-Weighted Imaging in Pediatric Arterial Ischemic Stroke: A Valuable Alternative for the Noninvasive Evaluation of Altered Cerebral Hemodynamics

Polan

Poretti

Huisman

et al. 2014

AJNR Am J Neuroradiol

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“…1,3 SWI may prove to be outstandingly useful in identifying the true extent of cavernous malformations or in confirming the presence of suspected small CCMs.…”

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confidence: 99%

Pneumocephalus Mimicking Cerebral Cavernous Malformations in MR Susceptibility-Weighted Imaging: Fig 1.

Palma¹,

Zubieta²,

Domínguez³

et al. 2009

AJNR Am J Neuroradiol

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We read with interest the article by de Souza et al 1 about the use of susceptibility-weighted imaging (SWI) for the evaluation of patients with cerebral cavernous malformations (CCMs). In this regard, we would like to report the following case: In November 2008, a 38-yearold woman presented with a history of left tinnitus and hypoacusis. The usual MR imaging sequences showed a left acoustic neurinoma; she also was found to have a single CCM in the left frontal region as an incidental finding. She underwent surgery, and a small CSF fistula presented through the surgical wound as complication. A new MR imaging was performed, adding SWI, showing several lesions that suggested the presence of multiple CCMs (in addition to the frontal cavernous malformation previously diagnosed) that were not seen on the usual sequences (Fig 1). The clinical correlation with the patient's medical history and a thorough analysis of the images led to the suspicion that the lesions seen on SWI corresponded to extra-axial air collections. A second intervention to close the CSF fistula and remove the frontal cavernous malformation was performed without complications, and the patient was discharged shortly after.SWI is a relatively new MR imaging technique suitable for detection of magnetic susceptibility effects.2 SWI is more sensitive than T2*-weighted gradient-refocused images in CCMs. 1,3 SWI may prove to be outstandingly useful in identifying the true extent of cavernous malformations or in confirming the presence of suspected small CCMs.However, as stated by Tong et al, 4 the loss of signal intensity created by a disturbance of a homogeneous magnetic field seen on SWI can be caused by various paramagnetic, ferromagnetic, or diamagnetic substances such as iron, some forms of calcification, or even air. Additionally, this fact may suggest that SWI could be a suitable sequence for monitoring the progress of recovery from pneumocephalus in neurosurgical patients. References

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“…Nowadays, susceptibility-weighted imaging (SWI) is increasingly used for the detection of microbleeds (28)(29)(30)(31)(32). In SWI the magnitude and phase images of the T2*-weighted scan are combined to create enhanced contrast between tissues with different susceptibilities (21).…”

Section: Discussionmentioning

confidence: 99%

Visualization of cerebral microbleeds with dual‐echo T2*‐weighted magnetic resonance imaging at 7.0 T

Conijn¹,

Geerlings²,

Luijten³

et al. 2010

Magnetic Resonance Imaging

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Purpose: To assess the visualization of cerebral microbleeds with dual echo T2*-weighted imaging at 7.0 T magnetic resonance imaging (MRI). Materials and Methods:Ten consecutive participants (eight men, two women, mean age 54 6 12 years) with vascular disease or risk factors from the second manifestations of arterial disease (SMART) study were included. Dual-echo T2*-weighted scans (echo time: 2.5/15.0 msec) were made for all participants at 7.0 T MRI. The number of visible microbleeds and the diameter of the microbleeds were recorded on minimal intensity projection images of both echoes. Results:The first echo image shows dark microbleeds against a homogeneous, more hyperintense signal of the brain tissue without contrast for veins and basal ganglia. In eight patients microbleeds were observed, with a total of 104 microbleeds. Of these, 88 (84.6%) were visible on the first and 102 (98.0%) on the second echo. The mean diameter of the microbleeds was 1.24 mm for the first echo and 2.34 mm for the second echo.Conclusion: T2*-weighted imaging at two echo times at 7.0 T combines the advantages of the first and second echo. Microbleeds visible on the first echo show large contrast with the surrounding tissue, even in the presence of paramagnetic ferritin. The second echo enables visualization of smaller microbleeds than the first echo.

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Detection of Hemorrhagic Hypointense Foci in the Brain on Susceptibility-Weighted Imaging

Cited by 81 publications

References 20 publications

Susceptibility-Weighted Imaging in Pediatric Arterial Ischemic Stroke: A Valuable Alternative for the Noninvasive Evaluation of Altered Cerebral Hemodynamics

Susceptibility-Weighted Imaging in Pediatric Arterial Ischemic Stroke: A Valuable Alternative for the Noninvasive Evaluation of Altered Cerebral Hemodynamics

Pneumocephalus Mimicking Cerebral Cavernous Malformations in MR Susceptibility-Weighted Imaging: Fig 1.

Visualization of cerebral microbleeds with dual‐echo T2*‐weighted magnetic resonance imaging at 7.0 T

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