Susceptibility weighted imaging (SWI) - A review of clinical applications in the brain

Congress:

ECR 2019

Poster Number:

C-1293

Type:

Educational Exhibit

Keywords:

Hypertension, Dementia, Education, MR, CNS, Neuroradiology brain, Trauma

Authors:

J. Arribas Garcia¹, A. Salazar², E. Alonso García², L. Adrián Lozano², E. Riñones Mena²; ¹Burgos, Burgos/ES, ²Burgos/ES

DOI:

10.26044/ecr2019/C-1293

DOI-Link:

https://dx.doi.org/10.26044/ecr2019/C-1293

Fig. 1: Combination of Phase mask and Magnitude Image to obtain SWI and MinIP...

Fig. 3: Differences between blood and calcium.

Fig. 4: Differences between blood and calcium.

Fig. 6: Cerebral amyloid angiopathy. Microbleeds on SWI.

Fig. 9: SWI of Diffuse Axonal Injury (DAI) showing hemorrhagic lesions in gray-white...

Fig. 13: MinIP SWI showing venous structures ("head of medusa") converging to a draining...

Fig. 19: Amyotrophic lateral sclerosis (ALS). SWI. Bilateral iron deposition in the...

Learning objectives

Physics behind the technique (magnitude and phase). To describe common findings seen in SWI sequence on a day to day basis of different CNS disorders. To discuss the potential and future applications.

Background

SWI is a relatively new developed technique in MRI increasingly used as routine in image services and helping in the diagnosis of many CNS disorders. It has superior sensibility compared with conventional T2*GRE as it is a high resolution 3D technique with flow compensation. It uses the magnetic susceptibility of different compounds like deoxygenated blood, blood degradation products, iron or calcium as a source of contrast in MR. There are some substances with paramagnetic, diamagnetic and ferromagnetic properties resulting in local heterogeneity of the local...

Findings and procedure details

Clinical applications: we review various neurovascular and neurodegenerative conditions in which SWI can help in diagnosis. Cerebral amyloid angiopathy: It is characteristic in this microangiopathy the deposition of amyloid β protein in the cerebral small arteries leading to fibrinoid necrosis and vessel fragility. They predominate in the frontal and parietal cortical and subcortical regions. It causes arteriolar microhemorrhages extending into the parenchyma. Also it is the main cause of primary lobar hemorrhage. It is important the differential diagnosis with microhemorrhages resulting from hypertensive or atherosclerotic...

Conclusion

Susceptibility weighted imaging (SWI) is a very useful tool and often offers complementary information to conventional MRI valuable in the diagnosis and treatment of various CNS disorders.

Personal information

Contact details: Dr. Javier Arribas García Neuroradiology section. Department of Radiology, Hospital Universitario de Burgos (HUBU). Av. Islas Baleares, 3, 09006 Burgos, Spain. Email:[email protected] Dra.Andrea Salazar Salgado Resident in training. Department of Radiology, Hospital Universitario de Burgos (HUBU). Av. Islas Baleares, 3, 09006 Burgos, Spain. Dra. Esther Alonso García Neuroradiology section. Department of Radiology, Hospital Universitario de Burgos (HUBU). Av. Islas Baleares, 3, 09006 Burgos, Spain. Dra. Laura Adrián Lozano Neuroradiology section. Department of Radiology, Hospital Universitario de Burgos (HUBU). Av. Islas Baleares, 3, 09006...

References

Halefoglu AM, Yousem DM. Susceptibility weighted imaging: Clinical applications and future directions. World J Radiol. 2018 Apr 28;10(4):30-45.Barbosa JH, Santos AC, Salmon CE. Susceptibility weighted imaging: differentiating between calcification and hemosiderin. Radiol Bras. 2015;48(2):93-100. Haacke EM, Mittal S, Wu Z, Neelavalli J, Cheng YC. Susceptibility-weighted imaging: technical aspects and clinical applications, part 1. AJNR Am J Neuroradiol. 2009 Jan;30(1):19-30. Mittal S, Wu Z, Neelavalli J, Haacke EM. Susceptibility-weighted imaging: technical aspects and clinical applications, part 2. AJNR Am J Neuroradiol. 2009 Feb;30(2):232-52. Gasparotti R, Pinelli...