Susceptibility-weighted imaging for differential diagnosis of cerebral vascular pathology: A pictorial review

Tsui, Yu-Kun; Tsai, Fong Y.; Hasso, Anton N.; Greensite, Fred; Nguyen, Binh V.

doi:10.1016/j.jns.2009.08.064

« Previous Next »Journal of the Neurological Sciences
Volume 287, Issue 1 , Pages 7-16, 15 December 2009

Susceptibility-weighted imaging for differential diagnosis of cerebral vascular pathology: A pictorial review

Yu-Kun Tsui
- Department of Radiological Sciences, University of California Irvine Medical Center, 101 City Drive South, Orange, CA 92868, USA
- Department of Radiology, Chi Mei Medical Center, Yong-Kang City, Tainan, Taiwan
Fong Y. Tsai
- Department of Radiological Sciences, University of California Irvine Medical Center, 101 City Drive South, Orange, CA 92868, USA
- Corresponding author. Tel.: +1 714 456 6984; fax: +1 714 456 8390.
Anton N. Hasso
- Department of Radiological Sciences, University of California Irvine Medical Center, 101 City Drive South, Orange, CA 92868, USA
Fred Greensite
- Department of Radiological Sciences, University of California Irvine Medical Center, 101 City Drive South, Orange, CA 92868, USA
Binh V. Nguyen
- Department of Radiological Sciences, University of California Irvine Medical Center, 101 City Drive South, Orange, CA 92868, USA

Received 5 February 2009; received in revised form 26 August 2009; accepted 28 August 2009. published online 23 September 2009.

Abstract

Susceptibility-weighted imaging (SWI) is a high-spatial resolution, three-dimensional, gradient-echo (GRE) magnetic resonance (MR) technique. This fully velocity-compensated pulse sequence utilizes the magnetic susceptibility differences of various tissues or substances, such as blood products, iron, and calcification. By postprocessing the magnitude images using a phase mask, it emphasizes the magnetic properties of different susceptibility effects. Generated minimal intensity projection (minIP) images can further demonstrate tortuous vasculature and the continuity of vessels or abnormalities across slices. SWI has been used to improve the diagnosis of neurological trauma, brain neoplasm, neurodegenerative disorders, and cerebrovascular disease because of its ability to demonstrate microbleeds and conspicuity of the veins and other sources with susceptibility effects. We have used SWI to identify cerebrovascular lesions which may be obscured on other MR sequences to aid in the differential diagnosis. We present a review with selected cases to demonstrate the usefulness of this new neuroimaging technique in improving the diagnosis of cerebral vascular pathology.

Keywords: Brain, Magnetic resonance imaging, Susceptibility-weighted imaging, Cerebral vascular pathology