IMPORTANCE It is uncertain whether coronavirus disease 2019 (COVID-19) is associated with a higher risk of ischemic stroke than would be expected from a viral respiratory infection. OBJECTIVE To compare the rate of ischemic stroke between patients with COVID-19 and patients with influenza, a respiratory viral illness previously associated with stroke.

Magnetic susceptibility of MS lesions increased rapidly as it changed from enhanced to nonenhanced, it attained a high susceptibility value relative to NAWM during its initial few years (approximately 4 years), and it gradually dissipated back to susceptibility similar to that of NAWM as it aged, which may provide new insight into pathophysiologic features of MS lesions. Online supplemental material is available for this article.

Purpose To quantitatively map cerebral metabolic rate of oxygen (CMRO2) and oxygen extraction fraction (OEF) in human brains using quantitative susceptibility mapping (QSM) and arterial spin labeling measured cerebral blood flow (CBF) before and after caffeine vasoconstriction. Methods Using the multiecho 3D gradient echo sequence and an oral bolus of 200 mg caffeine, whole brain CMRO2 and OEF were mapped at 3mm isotropic resolution on 13 healthy subjects. The QSM based CMRO2 was compared with an R2* based CMRO2 to analyze the regional consistency within cortical gray matter (CGM) with the scaling in the R2* method set to provide same total CMRO2 as the QSM method for each subject. Results Compared to pre-caffeine, susceptibility increased (5.1±1.1ppb, p<0.01) and CBF decreased (−23.6±6.7ml/100g/min, p<0.01) at 25min post-caffeine in CGM. This corresponded to a CMRO2 of 153.0±26.4µmol/100g/min with an OEF of 33.9±9.6% and 54.5±13.2% (p<0.01) pre- and post- caffeine respectively at CGM, and a CMRO2 of 58.0±26.6µmol/100g/min at white matter. CMRO2 from both QSM and R2* based methods showed good regional consistency (p>0.05), but quantitation of R2* based CMRO2 required an additional scaling factor. Conclusion QSM can be used with perfusion measurements pre- and post- caffeine vascoconstriction to map CMRO2 and OEF.

Quantitative susceptibility mapping (QSM) has enabled MRI of tissue magnetic susceptibility to advance from simple qualitative detection of hypointense blooming artifacts to precise quantitative measurement of spatial biodistributions. QSM technology may be regarded to be sufficiently developed and validated to warrant wide dissemination for clinical applications of imaging isotropic susceptibility, which is dominated by metals in tissue, including iron and calcium. These biometals are highly regulated as vital participants in normal cellular biochemistry, and their dysregulations are manifested in a variety of pathologic processes. Therefore, QSM can be used to assess important tissue functions and disease. To facilitate QSM clinical translation, this review aims to organize pertinent information for implementing a robust automated QSM technique in routine MRI practice and to summarize available knowledge on diseases for which QSM can be used to improve patient care. In brief, QSM can be generated with postprocessing whenever gradient echo MRI is performed. QSM can be useful for diseases that involve neurodegeneration, inflammation, hemorrhage, abnormal oxygen consumption, substantial alterations in highly paramagnetic cellular iron, bone mineralization, or pathologic calcification; and for all disorders in which MRI diagnosis or surveillance requires contrast agent injection. Clinicians may consider integrating QSM into their routine imaging practices by including gradient echo sequences in all relevant MRI protocols.