Hemorrhagic Shearing Lesions in Children and Adolescents with Posttraumatic Diffuse Axonal Injury: Improved Detection and Initial Results

Tong, Karen A.; Ashwal, Stephen; Holshouser, Barbara A.; Shutter, Lori; Hérigault, Gwénaël; Haacke, E. Mark; Kido, Daniel K.

doi:10.1148/radiol.2272020176

Cited by 387 publications

(271 citation statements)

References 18 publications

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“…Although SWI has been used as an MR venographic method for several years (13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26), it has more recently been applied to studies of arterial venous malformations (16,24), occult venous disease (15), multiple sclerosis (20), trauma (25), tumors (21,23,26), and functional brain imaging (14,22). Given the continued increasing clinical interest in this topic, it is important to ensure a complete understanding of the mathematical processes involved in creating SW images.…”

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confidence: 99%

Susceptibility weighted imaging (SWI)

Haacke¹,

Xu²,

Cheng³

et al. 2004

Magnetic Resonance in Med

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1,444

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Susceptibility differences between tissues can be utilized as a new type of contrast in MRI that is different from spin density, T 1 -, or T 2 -weighted imaging. Signals from substances with different magnetic susceptibilities compared to their neighboring tissue will become out of phase with these tissues at sufficiently long echo times (TEs). Thus, phase imaging offers a means of enhancing contrast in MRI. Specifically, the phase images themselves can provide excellent contrast between gray matter (GM) and white matter (WM), iron-laden tissues, venous blood vessels, and other tissues with susceptibilities that are different from the background tissue. Also, for the first time, projection phase images are shown to demonstrate tissue (vessel) continuity. In this work, the best approach for combining magnitude and phase images is discussed. The phase images are high-pass-filtered and then transformed to a special phase mask that varies in amplitude between zero and unity. This mask is multiplied a few times into the original magnitude image to create enhanced contrast between tissues with different susceptibilities.

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confidence: 99%

Susceptibility weighted imaging (SWI)

Haacke¹,

Xu²,

Cheng³

et al. 2004

Magnetic Resonance in Med

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1,228

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“…Our SWI technique is a novel imaging method that maximizes the sensitivity to susceptibility effects by combining a long-TE, high-resolution, fully flow-compensated, 3D gradient-echo sequence with filtered phase information in each voxel to both enhance the contrast in magnitude images and add a new source of information: the susceptibility difference between tissues (3). With the correct choice of resolution, the enhancement of small vessels and microhemorrhages is obtained (3,4). These characteristics permit SWI to have exquisite sensitivity to the venous vasculature (5), blood products (such as those that occur after hemorrhage), and vascular malformations (6,7).…”

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confidence: 99%

“…Techniques with increased sensitivity to blood products, such as SWI, may thus provide additional information to evaluate brain tumors (4). The ability to image tumor vasculature is necessary for the detection, developmental characterization, and assessment of tumor activity.…”

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confidence: 99%

Susceptibility‐weighted imaging to visualize blood products and improve tumor contrast in the study of brain masses

Sehgal

DelProposto

Haddar

et al. 2006

Magnetic Resonance Imaging

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Purpose:To evaluate the diagnostic value of susceptibilityweighted imaging (SWI) for studying brain masses. Materials and Methods:SWI is a high-resolution, threedimensional, fully velocity-compensated gradient-echo sequence that uses both magnitude and phase data. Custom postprocessing is applied to enhance the contrast in the magnitude images between tissues with different susceptibilities. This sequence was applied to 44 patients (24 males and 20 females, 15-89 years old, mean age ϭ 50.3 years) with brain masses, pre-and/or postcontrast, and compared with conventional sequences (T1, T1 postcontrast, T2, proton density (PD), fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) at 1.5T). Correlation with pathology was obtained in 12 cases. All images were reviewed independently by three radiologists. Results:In the evaluation of tumor visibility, boundary definition, blood products, venous vasculature, architecture, and edema, SWI gave better information than the standard T1-weighted postcontrast images in 11%, 14%, 71%, 73%, 63%, and 75% of the data, respectively, in a subgroup of 38 patients. This demonstrates that the information presented by SWI is complementary in nature to that available from conventional methods. On the whole, SWI was much more sensitive for showing blood products and venous vasculature. SWI showed a useful FLAIR-like contrast and complemented the information obtained by conventional T1 postcontrast sequences regarding the internal architecture of the lesions. Good pathologic correlations were found for blood products as predicted by SWI.Conclusion: SWI should prove useful for tumor characterization because of its ability to better highlight blood products and venous vasculature and reveal new internal architecture.

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“…The utility of FLAIR images in diagnosing swelling and subarachnoid hemorrhage was studied by many researchers 28,29,33 . New discoveries of images through diffusion (diffusion-weighted, apparent diffusion coefficient, diffusion tensor imaging) besides demonstrating diffuse axonal and ischemic lesions better, also indicate the prognostic more precisely [34][35][36][37] .…”

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confidence: 99%

Clinical application of magnetic resonance in acute traumatic brain injury

Morais

Spotti

Tognola

et al. 2008

Arq. Neuro-Psiquiatr.

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-Purpose:To evaluate the clinical applications of magnetic resonance imaging (MRI) in patients with acute traumatic brain injury (TBI): to identify the type, quantity, severity; and improvement clinical-radiological correlation. Method: Assessment of 55 patients who were imaged using CT and MRI, 34 (61.8%) males and 21 (38.2%) females, with acute (0 to 5 days) and closed TBI. Results: Statistical significant differences (McNemar test): ocurred fractures were detected by CT in 29.1% and by MRI in 3.6% of the patients; subdural hematoma by CT in 10.9% and MRI in 36.4 %; diffuse axonal injury (DAI) by CT in 1.8% and MRI in 50.9%; cortical contusions by CT in 9.1% and MRI in 41.8%; subarachnoid hemorrhage by CT in 18.2% and MRI in 41.8%. Conclusion: MRI was superior to the CT in the identification of DAI, subarachnoid hemorrhage, cortical contusions, and acute subdural hematoma; however it was inferior in diagnosing fractures. The detection of DAI was associated with the severity of acute TBI.Key woRDS: magnetic resonance imaging, traumatic brain injury. Aplicação clínica da ressonância magnética em pacientes com traumatismo craniencefálico agudoResumo -Propósito: Avaliar a aplicação clínica da ressonância magnética (RM) em pacientes vítimas de traumatismo craniencefálico (TCe) agudo, na identificação do tipo, número, gravidade e correlação clínica-radiológica. Método: Foram estudados prospectivamente 55 pacientes vítimas de TCe agudo fechado (0-5 dias), por TC e RM, sendo 34 do sexo masculino e 21 do feminino. Resultados: Houve diferença estatisticamente significante (teste McNemar): fraturas de crânio foram detectadas em 29,1% pacientes na TC e 3,6% pela RM; hematoma subdural 10,9% na TC e 36,4% pela RM; lesão axonal difusa (LAD) 1,8% pela TC e 50,9% na RM; contusões corticais 9,1% na TC e 41,8% pela RM, hemorragia subaracnóidea 18,2% na TC e 41,8% pela RM. Conclusão: A RM foi superior à TC na identificação da LAD, hemorragia subaracnóidea, contusões corticais e hematoma subdural agudo, porém inferior no diagnóstico de fraturas. A detecção de LAD pela RM foi associada com maior gravidade do TCe agudo. PALAVRAS-CHAVe: ressonância magnética, traumatismo craniencefálico.

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Hemorrhagic Shearing Lesions in Children and Adolescents with Posttraumatic Diffuse Axonal Injury: Improved Detection and Initial Results

Abstract: SW MR imaging depicts significantly more small hemorrhagic lesions than does conventional GRE MR imaging and therefore has the potential to improve diagnosis of DAI.

Cited by 387 publications

References 18 publications

Susceptibility weighted imaging (SWI)

Susceptibility weighted imaging (SWI)

Susceptibility‐weighted imaging to visualize blood products and improve tumor contrast in the study of brain masses

Clinical application of magnetic resonance in acute traumatic brain injury

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