Susceptibility-weighted imaging is more reliable than T2*-weighted gradient-recalled echo MRI for detecting...

Area of Science:

• Neuroimaging
• Radiology
• Cerebrovascular disease

Background:

• Cerebral microbleeds (CMBs) are small hemorrhages associated with various neurological conditions.
• Accurate detection and quantification of CMBs are crucial for diagnosis and monitoring.
• Routine MRI sequences like T2*-weighted gradient-recalled echo (GRE) have limitations in CMB detection.

Purpose of the Study:

• To compare the sensitivity and reliability of MRI susceptibility-weighted imaging (SWI) against routine T2*-weighted GRE for detecting cerebral microbleeds (CMBs).
• To determine the preferred MRI sequence for accurate CMB quantification.

Main Methods:

• A prospective study compared SWI and GRE sequences in patients with cerebral amyloid angiopathy and healthy controls.
• Three independent raters evaluated GRE and SWI images for CMB detection, blinded to clinical data.
• Inter-rater reliability was assessed using intraclass correlation coefficients and kappa coefficients.

Main Results:

• SWI identified more CMBs than GRE in both cerebral amyloid angiopathy cases and controls.
• Inter-rater reliability for CMB counts was substantially higher with SWI (ICC=0.87) compared to GRE (ICC=0.52).
• SWI's enhanced contrast and resolution improved CMB discrimination from background and vessels.

Conclusions:

• SWI demonstrates superior sensitivity and reliability for detecting cerebral microbleeds (CMBs) compared to GRE.
• SWI should be the preferred MRI sequence for quantifying CMBs due to its improved performance.
• The findings support the routine use of SWI in neuroimaging protocols for CMB assessment.