Role of SWI in Early Detection of Hemorrhagic Transformation in Acute Cerebral Ischemia

Background: The advent of new magnetic resonance imaging (MRI) techniques has improved acute stroke diagnosis. Susceptibility weighted imaging (SWI) has an important role in the management of cerebro-vascular strokes.

Patients and Method:The study was conducted upon 50 patients clinically diagnosed with cerebro-vascular strokes and referred to department of radio-diagnosis, Faculty of Medicine, Minia University. Computed tomography (CT) was done at first then magnetic resonance imaging was performed on a 1.5T Philips MR system using conventional MRI sequences as fluid attenuated inversion recovery (FLAIR), T2-weighted, T1-weighted and advanced sequences as susceptibility-weighted imaging (SWI) with the parameters including slice thickness, voxel size, field of view (FOV) and matrix,. They were done after the approval of ethical committee of our institution. Informed written consents were taken from the patients or their relatives.

Results: In our study, we found that 35 patients presented with acute non hemorrhagic infarction even on SWI and 15 patients presented with hemorrhagic infarction noted in SWI. Only ten of those patients with hemorrhagic infarction detected in CT. We found that detection rate of hemorrhage in SWI sequence was (100%). Detection rate of hemorrhage in CT was (33.3%). In SWI as regarding detection of different signs of acute ischemic strokes we found that of hemorrhage was (88%), detection rate of prominent cortical veins in vicinity of infarct was (62%) and detection rate of dark vessel sign was 6%. Comparative studies between them were done revealed that hemorrhage was the most important sign detected at SWI.

Conclusion: From this study we concluded that new imaging SWI MRI modality is a valuable MRI sequence in imaging hemorrhagic transformation in ischemic stroke.