Susceptibility weighted imaging: differentiating between calcification and hemosiderin

Barbosa, Jeam Haroldo Oliveira; Santos, Antônio Carlos dos; Salmon, Carlos Ernesto Garrido

doi:10.1590/0100-3984.2014.0010

Cited by 33 publications

(16 citation statements)

References 14 publications

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“…Furthermore, the additional areas of calcification appear to correspond to previously described areas of brain signal abnormality in HH summarized in Kumar et al [4] In addition to the standard T2*GRE sequence, susceptibility weighted imaging could provide a more sensitive evaluation of T2*GRE hypointensity and the "blooming" that results from magnetic field inhomogeneity, including from paramagnetic materials. Also, this imaging technique has some ability to differentiate different T2*GRE hypointense calcium from iron because of their different paramagnetic properties [13][14][15]. Unfortunately, susceptibility weighted imaging was not available in our case thus limiting the differentiation of iron and calcium brain deposits.…”

Section: Discussionmentioning

confidence: 90%

Idiopathic brain calcification in a patient with hereditary hemochromatosis

et al. 2020

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Background: Detection of brain-MRI T2/T2* gradient echo images (T2*GRE)-hypointensity can be compatible with iron accumulation and leads to a differential diagnosis work-up including neurodegeneration with brain iron accumulation (NBIA) and Wilson Disease. Idiopathic or secondary brain calcification can be also associated with neurological involvement and brain-MRI T2/T2*GRE-hypointensity. Hereditary hemochromatosis (HH), characterized by systemic iron loading, usually does not involve the CNS, and only sporadic cases of neurological abnormalities or brain-MRI T2/T2*GRE-hypointensity have been reported. Case presentation: A 59-year-old man came to our observation after a diagnosis of HH carried out in another hospital 2 years before. First-level genetic test had revealed a homozygous HFE p.Cys282Tyr (C282Y) mutation compatible with the diagnosis of HFE-related HH, thus phlebotomy treatment was started. The patient had a history of metabolic syndrome, type-2 diabetes, autoimmune thyroiditis and severe chondrocalcinosis. Brain-MRI showed the presence of bilateral T2*GRE hypointensities within globus pallidus, substantia nigra, dentate nucleus and left pulvinar that were considered expression of cerebral siderosis. No neurological symptoms or family history of neurological disease were reported. Neurological examination revealed only mild right-sided hypokinetic-rigid syndrome. Vitamin D-PTH axis, measurements of serum ceruloplasmin and copper, and urinary copper were within the normal range. A brain computed tomography (CT) was performed to better characterize the suspected and unexplained brain iron accumulation. On the CT images, the hypointense regions in the brain MRI were hyperdense. DNA sequence analysis of genes associated with primary familial brain calcification and NBIA was negative. Conclusions: This report highlights the importance of brain CT-scan in ambiguous cases of suspected cerebral siderosis, and suggests that HH patients with a severe phenotype, and likely associated with chondrocalcinosis, may display also brain calcifications. Further studies are needed to confirm this hypothesis. So far, we can speculate that iron and calcium homeostasis could be reciprocally connected within the basal ganglia.

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Section: Discussionmentioning

confidence: 90%

Idiopathic brain calcification in a patient with hereditary hemochromatosis

et al. 2020

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“…A imagem SWI tem demonstrado suas vantagens em retratar a arquitetura intratumoral abrangendo vasculatura venosa, hemoderivados, calcificação e edema 37 . Com a QSM, no entanto, tornou-se possível inequivocamente diferenciar depósitos de sangue paramagnéticos de calcificações diamagnéticas.…”

Section: Susceptibilidade Magnéticaunclassified

“…A QSM tem sido considerada uma técnica indireta para a quantificação de ferro 16,37 . O acúmulo de ferro cerebral detectado pela QSM tem sido associado à neurodegeneração em diversas doenças, não apenas na substância branca, mas também nos gânglios da base 10,38 .…”

Section: Susceptibilidade Magnéticaunclassified

Técnicas quantitativas de imagens por ressonância magnética

Castellano

Salmon²

2019

Rev Bras Fis Med

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ResumoTécnicas quantitativas de imagem são aquelas que permitem a mensuração de variáveis físicas ou químicas, passíveis de serem comparadas entre diferentes regiões anatômicas e indivíduos. Embora a maioria das técnicas baseadas em ressonância magnética mais utilizadas na clínica não sejam quantitativas, existem várias técnicas baseadas nesse fenômeno que o são. O objetivo desta revisão é fornecer uma breve descrição de algumas das principais técnicas quantitativas de imagens baseadas em ressonância magnética, assim como de suas aplicações. As técnicas descritas são: relaxometria, imagens ponderadas por difusão, imagens do tensor de difusão, imagens de susceptibilidade magnética, espectroscopia e imagens espectroscópicas. Palavras-chave: relaxometria; ponderação em difusão; tensor de difusão; susceptibilidade magnética; espectroscopia; imagens espectroscópicas. AbstractQuantitative imaging techniques are those that allow measurement of physical or chemical variables, which can be compared between different anatomical regions or subjects. Although the majority of the MRI techniques most commonly used in the clinic are not quantitative, many techniques based on this phenomenon are. The aim of this review is to provide a brief description of some of the main quantitative imaging techniques based on magnetic resonance, as well as of their applications. The techniques described are: relaxometry, diffusion-weighted imaging and diffusion-tensor imaging, magnetic susceptibility imaging, spectroscopy and spectroscopic imaging.

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“…Recent studies conducted in Brazil have highlighted the importance of MRI studies to improving the diagnosis of central nervous system disorders (1-5) . Kernicterus, also known as bilirubin encephalopathy, is a rare complication of hyperbilirubinemia in childhood, occurring when serum bilirubin levels in the neonate are in excess of 20 mg/dL at term or even lower values in premature infants, which result in bilirubin deposition in the globus pallidus, subthalamic nuclei, hippocampus, putamen, thalamus, and cranial nerves, primarily the third, fourth, and sixth cranial nerves (6) .…”

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confidence: 99%