Diagnosis of intracranial calcification and hemorrhage in pediatric patients: Comparison of quantitative susceptibility mapping and phase images of susceptibility-weighted imaging.

PURPOSE To prospectively compare the diagnostic capabilities of quantitative susceptibility mapping (QSM) with those of phase images of susceptibility-weighted imaging (SWI) in the detection and differentiation of intracranial calcification and hemorrhage in pediatric patients. METHOD Sixteen pediatric patients (9 girls, 7 boys) with a mean age of 9.4±6.3 (SD) years (range, 6 days-15 years) were included. Fifty-nine calcifications and 31 hemorrhages were detected. Sensitivities and specificities of the two magnetic resonance (MR) imaging techniques were calculated and compared using McNemar test. RESULTS QSM had a sensitivity of 84.7% and specificity of 100% for the detection of calcification. SWI phase images had a sensitivity of 49.1% and specificity of 100%. For the detection of hemorrhage, QSM had a sensitivity of 90.3% and a specificity of 98.3% whereas SWI phase images yielded a sensitivity of 64.5% and specificity of 96.6%. Overall, QSM displayed significantly better sensitivity than SWI phase images in identification of calcification and hemorrhage (P<0.05). CONCLUSION QSM is more reliable than SWI phase images in the identification of intracranial calcification and hemorrhage in pediatric patients using MR imaging.

[1]  Max Wintermark,et al.  Imaging of intracranial haemorrhage , 2008, The Lancet Neurology.

[2]  Sandeep Mittal,et al.  Identification of calcification with MRI using susceptibility‐weighted imaging: A case study , 2009, Journal of magnetic resonance imaging : JMRI.

[3]  Carlo Ciulla,et al.  Establishing a baseline phase behavior in magnetic resonance imaging to determine normal vs. abnormal iron content in the brain , 2007, Journal of magnetic resonance imaging : JMRI.

[4]  J. Reichenbach,et al.  Differentiation between diamagnetic and paramagnetic cerebral lesions based on magnetic susceptibility mapping. , 2010, Medical physics.

[5]  Torsten Rohlfing,et al.  MRI estimates of brain iron concentration in normal aging using quantitative susceptibility mapping , 2011, NeuroImage.

[6]  Chandrasekharan Kesavadas,et al.  Clinical applications of susceptibility weighted MR imaging of the brain – a pictorial review , 2008, Neuroradiology.

[7]  John A Butman,et al.  Comparison of MRI and CT for detection of acute intracerebral hemorrhage. , 2004, JAMA.

[8]  Yu-Chung N. Cheng,et al.  Susceptibility weighted imaging (SWI) , 2004, Zeitschrift fur medizinische Physik.

[9]  R. Henkelman,et al.  High signal intensity in MR images of calcified brain tissue. , 1991, Radiology.

[10]  K. Gumus Reconstruction of quantitative susceptibility maps. , 2015, Radiology.

[11]  M Takahashi,et al.  Detection of intracranial hemorrhage with susceptibility-weighted MR sequences. , 1999, AJNR. American journal of neuroradiology.

[12]  Sajja B Rao,et al.  Differentiation of Calcification from Chronic Hemorrhage with Corrected Gradient Echo Phase Imaging , 2001, Journal of computer assisted tomography.

[13]  P. Parizel,et al.  Intracranial hemorrhage: principles of CT and MRI interpretation , 2001, European Radiology.

[14]  N. Yamada,et al.  Intracranial calcification on gradient-echo phase image: depiction of diamagnetic susceptibility. , 1996, Radiology.

[15]  M. Canpolat,et al.  Susceptibility-Based Differentiation of Intracranial Calcification and Hemorrhage in Pediatric Patients , 2015, Journal of child neurology.

[16]  Yi Wang,et al.  Morphology enabled dipole inversion (MEDI) from a single‐angle acquisition: Comparison with COSMOS in human brain imaging , 2011, Magnetic resonance in medicine.

[17]  Yi Wang,et al.  A novel background field removal method for MRI using projection onto dipole fields (PDF) , 2011, NMR in biomedicine.

[18]  Tian Liu,et al.  Intracranial calcifications and hemorrhages: characterization with quantitative susceptibility mapping. , 2013, Radiology.