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Detection of microbleeds associated with sentinel headache using MRI quantitative susceptibility mapping: pilot study
Daichi Nakagawa1, Kohsuke Kudo2, Olatilewa Awe1
1Departments of1Neurosurgery.
Journal of Neurosurgery
|May 26, 2018
Summary
Sentinel headaches (SHs) linked to cerebral aneurysms (CAs) may indicate instability. This study shows magnetic resonance imaging quantitative susceptibility mapping (MRI-QSM) can detect associated microbleeds, identifying unstable CAs.
Area of Science:
- Neurology
- Radiology
- Medical Imaging
Background:
- Sentinel headaches (SHs) are associated with cerebral aneurysms (CAs), potentially indicating aneurysm instability.
- Microbleeds are a sign of unstable CAs but are difficult to detect with routine imaging.
Purpose of the Study:
- To detect microbleeds associated with SH using MRI quantitative susceptibility mapping (QSM).
- To evaluate morphological characteristics of unstable CAs with microbleeds.
Main Methods:
- Analyzed 20 CAs in 16 patients presenting with headache.
- Utilized MRI-QSM sequence for imaging.
- Performed 3D graphical, computational flow, and morphometric analyses.
Main Results:
- MRI-QSM identified microbleeds in 4 aneurysms associated with SH.
- QSM-positive aneurysms showed a significantly higher undulation index.
- Lower wall shear magnitude was observed near microbleeds in QSM-positive aneurysms.
Conclusions:
- MRI-QSM objectively detects microbleeds, aiding in the identification of unstable CAs.
- Aneurysm undulation index correlates with QSM-positive results and microbleeds.
- Larger studies are needed to validate these preliminary findings.
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