Susceptibility-weighted imaging to visualize blood products and improve tumor contrast in the study of brain masses.
OBJECTIVE
To evaluate the diagnostic value of susceptibility-weighted imaging (SWI) for studying brain masses.


METHODS
SWI is a high-resolution, three-dimensional, fully velocity-compensated gradient-echo sequence that uses both magnitude and phase data. Custom postprocessing is applied to enhance the contrast in the magnitude images between tissues with different susceptibilities. This sequence was applied to 44 patients (24 males and 20 females, 15-89 years old, mean age = 50.3 years) with brain masses, pre- and/or postcontrast, and compared with conventional sequences (T1, T1 postcontrast, T2, proton density (PD), fluid-attenuated inversion recovery (FLAIR) and diffusion-weighted imaging (DWI) at 1.5T). Correlation with pathology was obtained in 12 cases. All images were reviewed independently by three radiologists.


RESULTS
In the evaluation of tumor visibility, boundary definition, blood products, venous vasculature, architecture, and edema, SWI gave better information than the standard T1-weighted postcontrast images in 11%, 14%, 71%, 73%, 63%, and 75% of the data, respectively, in a subgroup of 38 patients. This demonstrates that the information presented by SWI is complementary in nature to that available from conventional methods. On the whole, SWI was much more sensitive for showing blood products and venous vasculature. SWI showed a useful FLAIR-like contrast and complemented the information obtained by conventional T1 postcontrast sequences regarding the internal architecture of the lesions. Good pathologic correlations were found for blood products as predicted by SWI.


CONCLUSIONS
SWI should prove useful for tumor characterization because of its ability to better highlight blood products and venous vasculature and reveal new internal architecture.
Sehgal
Vivek
V
MRI Radiology Department, Harper University Hospital, Detroit, Michigan, USA.
Delproposto
Zachary
Z
Haddar
Djamel
D
Haacke
E Mark
EM
Sloan
Andrew E
AE
Zamorano
Lucia J
LJ
Barger
Geoffery
G
Hu
Jiani
J
Xu
Yingbiao
Y
Prabhakaran
Karthik Praveen
KP
Elangovan
Ilaya R
IR
Neelavalli
Jaladhar
J
Reichenbach
Jürgen R
JR
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001927:Brain Diseases / Q000473:pathology; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D003287:Contrast Media / Q000494:pharmacology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis
D003287:Contrast Media