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Cerebral microbleeds: burden assessment by using quantitative susceptibility mapping
Tian Liu1, Krishna Surapaneni, Min Lou
1Department of Biomedical Engineering, Cornell University, Ithaca, NY, USA.
Purpose:
To assess quantitative susceptibility mapping (QSM) for reducing the inconsistency of standard magnetic resonance (MR) imaging sequences in measurements of cerebral microbleed burden.
Materials And Methods:
This retrospective study was HIPAA compliant and institutional review board approved. Ten patients (5.6%) were selected from among 178 consecutive patients suspected of having experienced a stroke who were imaged with a multiecho gradient-echo sequence at 3.0 T and who had cerebral microbleeds on T2*-weighted images. QSM was performed for various ranges of echo time by using both the magnitude and phase components in the morphology-enabled dipole inversion method. Cerebral microbleed size was measured by two neuroradiologists on QSM images, T2*-weighted images, susceptibility-weighted (SW) images, and R2* maps calculated by using different echo times. The sum of susceptibility over a region containing a cerebral microbleed was also estimated on QSM images as its total susceptibility. Measurement differences were assessed by using the Student t test and the F test; P < .05 was considered to indicate a statistically significant difference.
Results:
When echo time was increased from approximately 20 to 40 msec, the measured cerebral microbleed volume increased by mean factors of 1.49 ± 0.86 (standard deviation), 1.64 ± 0.84, 2.30 ± 1.20, and 2.30 ± 1.19 for QSM, R2*, T2*-weighted, and SW images, respectively (P < .01). However, the measured total susceptibility with QSM did not show significant change over echo time (P = .31), and the variation was significantly smaller than any of the volume increases (P < .01 for each).
Conclusion:
The total susceptibility of a cerebral microbleed measured by using QSM is a physical property that is independent of echo time.
Insights
Quantitative susceptibility mapping (QSM) offers consistent measurement of cerebral microbleed burden, unlike standard MRI sequences. QSM
Area of Science:
- Neuroimaging
- Radiology
- Medical Physics
Background:
- Cerebral microbleeds are common in stroke patients and can be detected using MRI.
- Standard MRI sequences show inconsistent measurements of microbleed burden.
- Quantitative susceptibility mapping (QSM) is an emerging MRI technique.
Purpose of the Study:
- To evaluate QSM's ability to reduce inconsistency in cerebral microbleed burden measurements.
- To compare QSM with standard MRI sequences (T2*-weighted, SWI, R2*) in measuring microbleeds.
Main Methods:
- Retrospective analysis of 10 stroke patients with cerebral microbleeds.
- Acquisition of multiecho gradient-echo MRI at 3.0 T.
- Measurement of microbleed size and total susceptibility using QSM and standard sequences across varying echo times.
Main Results:
- Microbleed volume measurements increased significantly with echo time for T2*-weighted, SWI, and R2* images (P < .01).
- QSM measurements of microbleed volume also increased with echo time (P < .01).
- Total susceptibility measured by QSM remained consistent across echo times (P = .31) and showed significantly less variation than volume measurements (P < .01).
Conclusions:
- The total susceptibility of cerebral microbleeds, as measured by QSM, is an echo time-independent physical property.
- QSM provides a more stable and reliable method for quantifying cerebral microbleed burden compared to standard MRI sequences.
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