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CSF Susceptibility Variation in Patient With Intracranial Hemorrhage: Implications for Quantitative Susceptibility

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Journal of Computer Assisted Tomography
|September 16, 2024
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Intracranial hemorrhage (ICH) significantly alters quantitative susceptibility mapping (QSM) when using cerebrospinal fluid (CSF) for regularization. This impacts QSM analysis in patients with bleeding, affecting non-hemorrhagic areas.

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Area of Science:

  • Magnetic Resonance Imaging (MRI)
  • Medical Imaging Analysis
  • Neuroimaging

Background:

  • Quantitative susceptibility mapping (QSM) is an MRI technique requiring regularization methods.
  • Cerebrospinal fluid (CSF) is commonly used for QSM regularization due to its water-like susceptibility.
  • The effect of blood in CSF on QSM regularization is not well understood.

Purpose of the Study:

  • To investigate the impact of intracranial hemorrhage (ICH) on using CSF as a reference for QSM.
  • To determine if ICH affects QSM values in non-hemorrhagic CSF.

Main Methods:

  • 87 subjects (53 with ICH, 37 without) underwent 3T MRI (3D multiecho gradient echo, FLAIR, mcTFI).
  • McTFI with and without CSF zero-referencing was generated and reviewed with FLAIR.
  • Hemorrhagic and non-hemorrhagic CSF regions were manually selected and analyzed.

Main Results:

  • Non-hemorrhagic CSF (H-) in ICH subjects showed higher regularized QSM values compared to non-ICH subjects.
  • Unregularized H- QSM values were also systematically higher in ICH subjects.
  • Subjects with Multiple Sclerosis (MS) but without ICH showed no significant difference in H- QSM values.

Conclusions:

  • ICH significantly alters QSM values in non-hemorrhagic CSF when using CSF regularization.
  • Hemorrhagic areas showed no significant QSM difference between regularized and unregularized images.
  • These findings have implications for intra- and intersubject QSM analysis in ICH patients.