-

Abstract

Objective: Susceptibility weighted imaging (SWI) is a novel magnetic resonance technique which uses tissue magnetic susceptibility differences to generate a unique contrast, different from that of spin density, T1, T2, and T2*. The subject of this study is to display the usability and the lesion detection sensitivity of the susceptibility weighted imaging sequence at the various clinic condition in neuroradiology.Methods: Between February 2009 - May 2009 in Taksim Education and Research Hospital 180 patients, 93 (51.7%) females and 87 (48.3%) males and mean age is 51,6 , are included to this study. T2* and SWI sequences were applied to all patients additional to conventional magnetic resonance imaging (MRI) sequences by using 1,5 Tesla MRI device (Magnetom Avanto; Siemens, Erlangen, Germany). Patients were compared with conventional and T2 * sequences in terms of visibility and appearance characteristics of lesions.Results: In our study, we found out that, 12 patients have traumatic and 10 patients have non-traumatic bleeding, 17 patients have mass, 14 patients have micro bleeding spots, 18 patients have vascular malformations, 19 patients have ischemic cerebral infarct, 5 patients have cerebral mineral depositions which is related to systemic or neurodegenerative disorders, 8 patients have multiple sclerosis and 48 patients have nonspecific findings. In 30 patients no pathologic findings have been found.Conclusion: SWI sequence is a new MRI imaging sequence which is sensitive in detection of pathologies like macro-micro bleeding, mineral depositions, low-flow vascular lesions, internal architecture of the cranial masses, and also showing hemorrhagic transformations in cerebral infarcts without anatomical detail loss

Keywords

• Susceptibility weighted imaging, neuroradiology, magnetic resonance imaging

Nöroradyolojide “Susceptibility Weighted Imaging sekansı” uygulamaları

Abstract

Amaç: Klinik uygulamaya yakın zamanda giren Susceptibility Weighted Imaging (SWI) sekansı dokuların manyetik yatkınlık farklarını kullanarak kontrast oluşturan, T1, T2, T2* ve proton dansitesinden farklı yeni bir sekanstır. Çalışmamızda, nöroradyolojide susceptibility weighted imaging sekansının kullanılabilirliği ve lezyon saptamadaki duyarlılığının ortaya konması amaçlandı.

Yöntemler: Şubat 2009- Mayıs 2009 tarihleri arasında S.B. Taksim Eğitim ve Araştırma Hastanesinde klinisyen tarafından magnetik rezonans (MR) istemi yapılmış ortalama 51,6 yaşında (Aralık: 5-86) ,93’ü (%51,7) kadın ve 87’si (%48,3) erkek 180 hasta çalışmaya dahil edildi. Tüm hastalara 1,5-T MR cihazı (Magnetom Avanto; Siemens, Erlangen, Almanya) kullanılarak konvansiyonel sekanslara ek olarak aksiyal T2* ve SWI sekansları ile görüntüler alındı. Hastalar lezyon görülebilirliği ve görünüm özellikleri açısından konvansiyonel ve T2* sekans ile karşılaştırıldı.

Bulgular: Çalışmamızda 12 hastada travmatik, 10 hastada notravmatik kanama, 17 hastada kitle, 14 hastada mikrokanama odakları, 18 hastada vasküler malformasyon, 19 hastada iskemik serebral enfarkt, 5 hastada sistemik veya nörodejeneratif hastalığa bağlı serebral minereal birikimi, 8 hastada multiple skleroz ve 48 hastada nonpesifik bulgular saptanmıştır. Toplam 30 hastada ise herhangi bir patolojik bulgu saptanmamıştır.

Sonuç: SWI sekansı, anatomik detay kaybı olmaksızın yavaş akımlı vasküler lezyonlar, mikro-makro kanamalar, mineral birikimini saptamada, kranial kitlelerin iç yapısını anlamada ve serebral enfarktlarda hemorajik transformasyonu saptamada duyarlı yeni bir MR sekansıdır.

Anahtar kelimeler: Susceptibility weighted imaging, nöroradyoloji, manyetik rezonans görüntüleme

Keywords

• Susceptibility weighted imaging, nöroradyoloji, manyetik rezonans görüntüleme

References

1. Haacke EM, Mittal S, Wu Z, et al. Susceptibility-weighted
2. imaging: technical aspects and clinical applications, Part I.
3. AJNR Am J Neuroradiol. 2009;30:19-30.
4. Reichenbach JR, Haacke EM. High-resolution BOLD venographic imaging: a window into brain function. NMR
5. Biomed 2001;14:453-467.
6. Wycliffe ND, Choe J, Holshouser B, et al. Reliability in
7. detection of hemorrhage in acute stroke by a new threedimensional gradient recalled echo susceptibility-weighted
8. imaging technique compared to computed tomography: a

9. retrospective study. J Magn Reson Imaging 2004;20:372-377.
10. Nighoghossian N, Hermier M, Adeleine P, et al. Old microbleeds are a potential risk factor for cerebral bleeding after
11. ischemic stroke: a gradient-echo T2*-weighted brain MRI
12. study. Stroke 2002;33:735-742.
13. Hermier M, Nighoghossian N, Derex L, et al. MRI of acute
14. post-ischemic cerebral hemorrhage in stroke patients: diagnosis with T2*-weighted gradientecho sequences. Neuroradiology 2001;43:809-815.
15. Thomas B, Somasundaram S, Thamburaj K, et al. Clinical
16. applications of susceptibility weighted MR imaging of the
17. brain: a pictorial review. Neuroradiology 2008;50:105-116.
18. Lee BCP, Vo KD, Kido DK et al MR high resolution
19. blood oxygenation level dependent venography of occult (low-flow) vascular lesions. AJNR Am J Neuroradiol 1999;20:1239-1242.
20. Reichenbach JR, Jonetz-Mentzel L, Fitzek C, et al. High
21. resolution blood oxygen level dependent MR venography
22. (HRBV): a new technique. Neuroradiology 2001;43:364-369.
23. Won Seo S, Hwa Lee B, Kim EJ, et al. Clinical significance
24. of microbleeds in subcortical vascular dementia. Stroke
25. ;38:1949e51.
26. Haacke EM, DelProposto ZS, Chaturvedi S, et al. Imaging
27. cerebral amyloid angiopathy with susceptibility-weighted
28. imaging. AJNR Am J Neuroradiol 2007;28:316-17.
29. Larsen JP, Britt W, Kido D, et al. Susceptibility weighted
30. magnetic resonance imaging in evaluation of dementia. Radiology Case Reports 2007;2:102.
31. Tong KA, Ashwal S, Holshouser BA, et al. Hemorrhagi
32. shearing lesions in children and adolescents with posttraumatic diffuse axonal injury: improved detection and initial results. Radiology 2003;227:332e9.
33. Tong KA, Ashwal S, Holshouser BA, et al. Diffuse axonal
34. injury in children: clinical correlation with hemorrhagic lesions. Ann Neurol 2004;56:36-50.
35. Babikian T, Freier MC, Tong KA, et al. Susceptibility
36. weighted imaging: neuropsychologic outcome and pediatric head injury. Pediatr Neurol 2005; 33:184-194.
37. Haacke EM, Mittal S, Wu Z, et al. Susceptibility-weighted
38. imaging: technical aspects and clinical applications, Part 2.
39. AJNR Am J Neuroradiol. 2009;30:232-252.
40. Seghal V, Delproposto Z, Haacke EM et al Clinical applications of neuroimaging with susceptibility-weighted imaging. J Magn Reson Imaging 2005;22:439-450.
41. Lin W, Mukherjee P, An H et al. Improving high resolution
42. MR bold venographic imaging using a T1 reducing contrast
43. agent. J Magn Reson Imaging 1999;10:118-123.
44. Oot RF, New PF, Pile-Spellman J, et al. The detection of
45. intracranial calcifications by MR. AJNR Am J Neuroradiol
46. ;7:801-809.
47. Avrahami E, Cohn DF, Feibel M, et al. MRI demonstration
48. and CT correlation of the brain in patients with idiopathic
49. intracerebral calcification. J Neurol 1994;241:381-384.
50. Tsuchiya K, Makita K, Furui S, et al. MRI appearances of
51. calcified regions within intracranial tumors. Neuroradiology 1993;35:341-344.
52. Wu Z, Mittal S, Kish K, et al. Identification of calcification with magnetic resonance imaging using susceptibilityweighted imaging: a case study. J Magn Reson Imaging 2009;29:177-182.
53. Harder SL, Hopp KM, Ward H, et al. Mineralization of the
54. deep gray matter with age: a retrospective review with susceptibility-weighted MR imaging. AJNR Am J Neuroradiol
55. ;29:176-183.
56. Qian ZM, Shen X. Brain iron transport and neurodegeneration. Trends Mol Med 2001;7:103-108.