Magnetic resonance susceptibility weighted in evaluation of cerebrovascular diseases

Amr Yehia Abd Elmotelb Sultan,Rasha Mahmoud Dawoud,Omar Ahmed Hassanien,Khalid Ismael Elshafey

doi:10.1186/s43055-020-00198-y

Amr Yehia Abd Elmotelb Sultan, Rasha Mahmoud Dawoud + Show 2 more

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https://doi.org/10.1186/s43055-020-00198-y

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Abstract

BackgroundCerebrovascular diseases are considered a very hard burden as they may lead to poor outcome, and they are considered the second most common cause of morbidity and mortality after coronary artery disease. They include wide variety of diseases that affect vascularity of brain tissue with the most common one is stroke—either ischemic or hemorrhagic. The aim of the current study was to assess the role of susceptibility weighted imaging (SWI) in imaging of different cerebrovascular diseases and what would be added by SWI to different routine magnetic resonance imaging (MRI) sequences.ResultsFifty-five patients enrolled in this study, 14 patients had lesions with calcifications, 13 patients had cavernoma, 10 patients had diffuse axonal injury, 11 patients with infarction, 2 patients with AVM, 2 patients with chronic microbleed, 2 patients with hemorrhage, and 1 patient with hemorrhagic tumor, and the result showed that SWI has sensitivity 100%, specificity 60%, and accuracy 91.9% in regard to diagnosis of cavernoma while sensitivity 91.7%, specificity 50%, and accuracy 85.7% in regard to diagnosis of calcification and regarding diagnosis of diffuse axonal injury; SWI has 98.3% sensitivity, 100% specificity, and 98.4% accuracy; finally, in regard to diagnosis of hemorrhagic lesions, SWI has 96.1% sensitivity, 66.7% specificity, and 93.1% accuracy.ConclusionSWI is very sensitive in the diagnosis and detection of actual number of vascular malformation like cavernomas than conventional MRI. SWI adds significant diagnostic value to routine MRI sequences in regard to calcification that was nearly limited in its diagnosis by CT. Diagnosis of microbleeds becomes easier and accurate with SWI. Diffuse axonal injury was and still considered a clinical diagnosis, but SWI becomes the gold standard in its imaging diagnosis confirming the clinical one.

Highlights

Cerebrovascular diseases are considered a very hard burden as they may lead to poor outcome, and they are considered the second most common cause of morbidity and mortality after coronary artery disease
This study included 55 patients; the age of the patients ranged from 1 year and 4 months to 64 years old with a mean of 34 ± 14.9 years and median of 43.5 years; fourteen patients (25.4%) had calcifications at different sites with different pathologies, 13 patients (23.6%) had cavernomas, 11 patients (20%) had infarction (9 patients had hemorrhagic infarction and 2 patients had nonhemorrhagic infarction), 10 patients (18.1%) had diffuse axonal injury (DAI), 2 patients (3.6%) had AVM, 2 patients (3.6%) had microbleeds, 2 patients (3.6%) had hemorrhage, and 1 patient (1.8%) had hemorrhagic tumor (Table 1)
Regarding the diagnosis of cavernoma (Fig. 1) Among the 55 patients examined in this study, 13 patients were diagnosed with cavernoma(either sporadic or inherited) on the basis of specific signals on different magnetic resonance imaging (MRI) sequences with no obvious common risk factor between the patients, but with positive family history of the same pathology in 9 patients

Summary

Introduction

Cerebrovascular diseases are considered a very hard burden as they may lead to poor outcome, and they are considered the second most common cause of morbidity and mortality after coronary artery disease They include wide variety of diseases that affect vascularity of brain tissue with the most common one is stroke—either ischemic or hemorrhagic. Cerebrovascular disease includes a variety of medical conditions that affect the blood vessels of the brain and the cerebral circulation It is considered the second leading cause of morbidity and mortality after coronary artery diseases. The basic concept of this technique is maintaining phase information into the final image, discarding phase artifacts, and keeping just the local phase of interest It utilizes the phase information and signal loss to reveal the susceptibility differences between various tissues and substances like blood products, iron, and calcification [5, 6]

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