Black dots in bad brains - narrowing the differential in SWI abnormalities

Congress:

ECR 2018

Poster Number:

C-2796

Type:

Educational Exhibit

Keywords:

Imaging sequences, Education, MR, Neuroradiology brain, CNS, Pathology

Authors:

H. Nejadhamzeeigilani, H. Cliffe, I. Craven, S. Currie; Leeds/UK

DOI:

10.1594/ecr2018/C-2796

DOI-Link:

https://dx.doi.org/10.1594/ecr2018/C-2796

Fig. 5: Imaging relates to a 16-year-old female with a history of acute lymphoblastic...

Fig. 6: Imaging relating to a 3-year-old girl who presented with seizures that were...

$Fig. 15: 22-year-old male presenting following a tibio-fibular fracture (a) complicated by fat embolism. T2 and FLAIR axial images demonstrate multifocal hyper intensities, involving the deep white matter, basal ganglia and cerebellar hemispheres. SWI images show extensive blooming artefacts.$

Fig. 15: 22-year-old male presenting following a tibio-fibular fracture (a) complicated...

Fig. 13: 27-year-old female with biochemical findings in keeping with Wilson’s. The...

Learning objectives

To recognise the imaging characteristics of a spectrum of pathologies that cause abnormalities on the susceptibility-weighted imaging (SWI) sequence of magnetic resonance (MR) studies in order to aid accurate diagnosis.

Background

SWI is a relatively new MR technique which allows the visualisation of magnetic susceptibility changes caused by various substances, including iron. Given that iron plays an important role in numerous conditions, the clinical application of SWI are vast. The combination of magnitude and phase data results in an enhanced contrast magnitude image, which is more sensitive to magnetic susceptibility changes than T2* gradient echo (GE) sequence images. The abnormality of importance on SWI is blooming; a susceptibility artefact encountered in the presence of paramagnetic substances....

Findings and procedure details

The pattern and distribution of blooming signal loss is a good differentiator for several pathologies on SWI. This poster will explore this differentiation by examining a range of conditions incorporating vascular, infectious, inflammatory, neoplastic, neurodegenerative and traumatic pathologies. In this section we will explore the clinical applications of SWI with a particular focus on differentiating features for various pathologies. Case contents: Vascular Hypertensive angiopathy(Fig. 4) Venous Sinus Thrombosis ( Fig. 5) Cavernous malformation ( Fig. 6) Telangectasia Delopmental venous anomaly Superficial Siderosis Stroke Infectious Abscess...

Conclusion

SWI has established itself as a powerful tool in brain imaging for the detection of a sizeable range of pathologies and should be incorporated into routine brain MR protocols. As such, it is vital for radiologists to ensure familiarity with several related important features in order to make accurate diagnoses.

Personal information

References

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