Reliability in detection of hemorrhage in acute stroke by a new three‐dimensional gradient recalled echo susceptibility‐weighted imaging technique compared to computed tomography: A retrospective study

Abstract

Purpose:To compare the sensitivity of magnetic resonance (MR) susceptibility-weighted imaging (SWI) with conventional MR sequences and computed tomography (CT) in the detection of hemorrhage in an acute infarct. Materials and Methods:A series of 84 patients suspected of having acute strokes had both CT and MR imaging (MRI) scans with diffusion-weighted imaging (DWI) and SWI. The SWI sequence is a new high-resolution three-dimensional (3D) imaging technique that amplifies phase to enhance the magnitude contrast.Results: Thirty-eight of 84 cases showed abnormal DWI consistent with acute infarct. Of the 38, SWI showed evidence of hemorrhage in 16 cases, compared to eight cases with spin echo (SE) T2, seven cases with fluid attentuated inversion recovery (FLAIR), and only five cases with CT. In a subset of 17 cases of acute infarct who had both twodimensional gradient recalled echo (2D-GRE) T2*-weighted imaging and SWI, in addition to conventional MRI, evidence of hemorrhage was seen in 10 cases using SWI, compared to seven cases with 2D-GRE T2*.Conclusion: SWI proved to be a powerful new approach for visualizing hemorrhage in acute stroke compared to CT and conventional MRI methods.

“Brush Sign” on Susceptibility-Weighted MR Imaging Indicates the Severity of Moyamoya Disease

“…Uncoupling between oxygen supply and demand in hypoperfused tissue may cause a relative increase of deoxyhemoglobin levels and a decrease of oxyhemoglobin in the tissue capillaries and the draining veins. Therefore, SWI has been applied to various pathologies of the brain that affect magnetic inhomogeneity, such as stroke, 8,11 trauma, 8 cerebral cavernous malformation, 12,13 arteriovenous malformation, 14 dural arteriovenous fistula, 15 pathophysiology affecting iron storage conditions, [16][17][18] brain tumor, 19 and cerebral amyloid angiopathy. 20 It is noteworthy that this method has the potential to demonstrate increased oxygen extraction in focal cerebral ischemia.…”

High-field MRI of brain cortical substructure based on signal phase

“…Several recent studies have shown that the use of MRI signal phase in gradient-echo (GRE) MRI can improve contrast MRI in specific human brain structures, including veins and iron-rich regions (10)(11)(12)(13)(14). Preliminary studies have also shown a substantial contrast between WM and cortical GM (11,15).…”

Intracranial Hemorrhage and Tortuosity of Veins Detected on Susceptibility-weighted Imaging of a Child with a <i>Type IV Collagen α1</i> Mutation and Schizencephaly

“…Previous investigators have shown that SWI is more sensitive than conventional MR imaging sequences or CT for detecting foci of hemorrhages. 5 In this case, SWI detected more foci of hemorrhages than conventional sequences. Because conventional MR imaging showed faint signal changes at the corresponding locations of the foci of the hemorrhage without parenchymal edema, the foci of the hemorrhage may be chronic.…”