Contrast medium enhanced susceptibility imaging signal mechanism; should we use contrast medium?. (January 2017)

• Record Type: Journal Article
• Authors: Aydın, Ömer; Büyükkaya, Ramazan; Hakyemez, Bahattin
• Is Part Of: Acta radiologica. Volume 58:Number 1(2017:Jan.)
• Page Start: 107
• Page End: 113
• Publication Date: 2017-01
• Subjects: Contrast medium -- susceptibility weighted imaging -- blood brain barrier -- angiogenesis -- tumor; Radiology, Medical -- Periodicals; Radiography, Medical -- Periodicals; Radiotherapy -- Periodicals; 616.0757
• DOI: 10.1177/0284185116637246
• Languages: English
• ISSNs: 0284-1851

Abstract

Background: Intracranial lesions exhibit clear contrast enhancement in T1-weighted imaging, but the mechanism whereby contrast-enhanced susceptibility-weighted imaging (CE-SWI) generates signals remains unclear. Contrast enhancement patterns cannot be reliably predicted. Purpose: To explore the mechanism of CE-SWI contrast enhancement. Material and Methods: Fifty-five patients were retrospectively enrolled. All of the imaging employed a clinical 3T magnetic resonance imaging (MRI) system fitted with a 32-channel head coil. Minimum-intensity projection reformatted images were evaluated. Intracranial lesions and brain parenchymal intensities were explored using SWI and CE-SWI. signal intensity rates were calculated by dividing the lesional intensity by the white matter intensity, after which the SWI and CE-SWI signal intensity rate were compared. Two observers independently performed intralesional susceptibility signal analysis. Results: After contrast medium administration, malignant and extra-axial tumors exhibited obvious contrast enhancement on CE-SWI ( P < 0.001 and P = 0.013, respectively). The signal intensity of white matter was significantly reduced. The signal intensity rates rose significantly in the benign, malignant, and extra-axial groups ( P < 0.001). Between-radiologist agreement in terms of intralesional susceptibility signal assessment was strong (kappa = 0.8, P < 0.001). Conclusion: Contrast media can either reduce or increase SWI signal intensities. The dual contrast feature of CE-SWI can be useful when exploring intracranial disorders.