NÖRORADYOLOJİ PRATİĞİNDE SUSCEPTIBILITY WEIGHTED IMAGING (SWI) MRG SEKANS KULLANIM ALANLARI

Amaç: Susceptibility Weighted Imaging (SWI) sekansı deoksihemoglobin, intrasellüler hemoglobin ve hemosiderin gibi kan ürünleri ile demir ve kalsiyum gibi minerallerin manyetik duyarlılıklarını kullanarak yüksek çözünürlüklü, üç boyutlu, magnifiye ve faz imajlardan ve bunların kombinasyonundan oluşan gradient ağırlıklı yeni bir MR sekansıdır. SWI sekansının nöroradyoloji pratiğinde kullanılabilirliği ve lezyon saptamadaki duyarlılığının ortaya konması amaçlandı.Materyal ve Metod: Nisan 2010-Mayıs 2011 tarihleri arasında 1-87 yaşları arasında 70 hasta (40 erkek, 30 kadın) incelemeye dâhil edildi. Tüm olgulara 1,5 T MR cihazı ile rutin konvansiyonel MRG incelemesine SWI sekansı dahil edildi. SWI sekansının lezyon tesbit etmedeki duyarlılığı hesaplandı.Bulgular: Çalışmamızda 18 hastada iskemik serebral enfarkt, 7 hastada nontravmatik, 7 hastada travmatik kanama, 10 hastada vasküler malformasyon, 21 hastada intrakranial kitle, 7 hastada nörodejeneratif hastalığa bağlı serebral minereal birikimi. SWI sekansı konvansiyonel sekanslarla karşılaştırıldığında mikro-makro kanamaların, venöz malformasyonların ve mineral birikiminin belirginliğini ve görünürlüğünü artırmaktadır. Sonuç: SWI sekansı, mikro ve makro kanama, lezyon içine kanamaları göstermede, kranial kitlelerin sınırlarının daha doğru tespitinde, serebral enfarktlar da hemorajik evreyi sapatamada, hücre içi mineral birikimi gibi birçok patolojinin saptanmasında, duyarlı yeni bir MR görüntüleme sekansıdır.

Anahtar Kelimeler:

Manyetik Rezonans Görüntüleme; Serebral; Lezyon

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KAYNAKLAR
1. Lauterbur PC. Image formation by induced local interactions: examples of employing nuclear magnetic resonance. Nature 1973; 242:190-1.
2. Hadley DM, Teasdale GM. Magnetic resonance imaging of the brain and spine. J Neu-rol. 1988;235(4):193-206.
3. Haacke EM, Xu Y, Cheng YC, Reichenbach JR: Susceptibility weighted imaging (SWI). Magn. Reson. Med 2004; 52: 612-8.
4. Tong KA, Ashwal S, Obenaus A, Nickerson JP, Kido D, Haacke EM. Susceptibility-Weighted MR imaging: a review of clinical applications in children. AJNR Am J Neuroradiol. 2008;29(1):9-17.
5. Haacke EM, Mittal S, Wu Z, Neelavalli J, Cheng YC. Susceptibility-weighted imaging: technical aspects and clinical applications, Part I. AJNR Am J Neuroradiol. 2009;30:19-30.
6. Teke M, Kına A, Sarıca Ö, Albayram S. Nöroradyolojide “Susceptibility Weighted Imaging sekan-sı” uygulamaları. Dicle Tıp Dergisi. 2015; 42 (2): 235-41.
7 Patel MR, Edelman RR, Warach S. Detection of hyperacute primary intraparenchymal hemorrhage by magnetic resonance imaging. Stroke. 1996;27(12):2321-4.
8 Tong KA, Ashwal S, Holshouser BA, Shutter LA, Herigault G, Haacke EM, et al. Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury: improved detection and initial results. Radiology 2003;227(2):332-9.
9. Santhosh K, Kesavadas C, Thomas B, Gupta AK, Thamburaj K, Kapilamoorthy TR. Susceptibility weighted imaging: a new tool in magnetic resonance imaging of stroke. Clinical Radiology 2009; 64:74-83.
10. Nighoghossian N, Hermier M, Adeleine P, Blanc-Lasserre K, Derex L, Honnorat J, et al. Old microbleeds are a potential risk factor for cerebral bleeding after ischemic stroke. A gradient-echo T2*-weighted brain MRI study. Stroke 2002; 33: 735-42.
11. Kidwell CS, Saver JL, Villablanca JP, Duckwiler G, Fredieu A, Gough K, et al. Magnetic resonance imaging detection of microbleeds before thrombolysis: an emerging application. Stroke 2002; 33: 95-8.
12. Derex L, Nighoghossian N, Hermier M, Adeleine P, Philippeau F, Honnorat J, et al. Thrombolysis for ischemic stroke in patients with old microbleeds on pretreatment MRI. Cerebrovasc Dis 2004; 17: 238-41.
13. Schellinger PD, Jansen O, Fiebach JB, Hacke W, Sartor K. A standardized MRI stroke protocol: comparison with CT in hyperacute intracerebral hemorrhage. Stroke 1999; 30: 765–8.
14. Wycliffe ND, Choe J, Holshouser B, Oyoyo UE, Haacke EM, Kido DK. Reliability in detection of hemorrhage in acute stroke by a new three-dimensional gradient recalled echo susceptibility-weighted imaging technique compared to computed tomography: a retrospective study. J Magn Reson Imaging 2004; 20: 372–7.
15. Tong KA, Ashwal S, Holshouser BA, Nickerson JP, Wall CJ, Shutter LA. Diffuse axonal injury in children: clinical correlation with hemorrhagic lesions. Ann Neurol 2004; 56: 36–50.
16 Tong KA, Ashwal S, Holshouser BA, Shutter LA, Herigault G, Haacke EM. Hemorrhagic shearing lesions in children and adolescents with posttraumatic diffuse axonal injury: improved detection and initial results. Radiology 2003; 227:332–39.
17. Babikian T, Freier MC, Tong KA, Nickerson JP, Wall CJ, Holshouser BA et al. Susceptibility weighted imaging: neuropsychologic outcome and pediatric head injury. Pediatr Neurol 2005; 33: 184–94.
18. Mannion RJ, Cross J, Bradley P, Coles JP, Chatfield D, Carpenter A, et al. Mechanism-based MRI classification of traumatic brainstem injury and its relationship to outcome. J Neurotrauma 2007; 24: 128–35.
19. Yoshida Y, Terae S, Kudo K, Tha KK, Imamura M, Miyasaka K. Capillary telengiectasia of the Brain Stem Diagnosed by Susceptibility-Weighted Imaging J.Comput Assist Tomogr 2006;30 (6):980-2.
20. Battistini S, Rocchi R, Cerase A, Citterio A, Tassi L, Lando G, et al. Clinical, magnetic resonance imaging, and genetic study of 5 Italian families with cerebral cavernous malformation. Arch Neurol 2007; 64: 843–48.
21. Abla A, Wait SD, Uschold T, Lekovic GP, Spetzler RF. Developmental venous anomaly, cavernousmalformation, and capillary telangiectasia: spectrum of a single disease. Acta Neurochir (Wien) 2008;150:487- 9.
22 Reichenbach JR, Venkatesan R, Schillinger DJ. Small vessels in the human brain: MR venography with deoxyhemoglobin as an intrinsic contrast agent. Radiology, 1997; 204: 272–7.
23. Sehgal V, Delproposto Z, Haacke EM, Tong KA, Wycliffe N, Kido DK, et al. Clinical applicati-ons of neuroimaging with susceptibility-weighted imaging. J.Magn Reson I 2005;22:439-50.
24. Bagley LJ, Grossman RI, Judy KD, Curtis M, Loevner LA, Polansky M, et al. Gliomas: correlation of magnetic susceptibility artifact with histologic grade. Radiology 1997; 202:511–6.
25. Sehgal V, Delproposto Z, Haddar D, Haacke EM, Sloan AE, Zamorano LJ et al. Susceptibility-weighted imaging of brain masses. J Magn Reson Imaging 2006 Jul;24(1):41-51.
26. Cha S, Knopp EA, Johnson G, Wetzel SG, Litt AW, Zagzag D. Intracranial mass lesions: dynamic contrast-enhanced susceptibility-weighted echo-planar perfusion MR imaging. Radiology 2002; 223: 11–29.
27. Lin W, Mukherjee P, An H, Yu Y, Wang Y, Vo K, et al. Improving high resolution MR bold venographic imaging using a T1 reducing contrast agent. J Magn Reson Imaging 1999;10:118-23.
28. Oot RF, New PF, Pile-Spellman J, Rosen BR, Shoukimas GM, Davis KR. The detection of intracranial calcifications by MR. AJNR Am J Neuroradiol 1986; 7: 801–9.
29. Tsuchiya K, Makita K, Furui S, Nitta K. MRI appearances of calcified regions within intracranial tumors. Neuroradiology 1993; 35: 341–4.
30. Mueller J, Stojkovic M, Kauczor HU, Junghanss T, Weber TF. Performance of Magnetic Reso-nance Susceptibility-Weighted Imaging for Detection of Calcifications in Patients With Hepatic Echi-nococcosis. J Comput Assist Tomogr. 2018;42(2):211-5.31. Bartzokis G, Cummings JL, Markham CH, Marmarelis PZ, Treciokas LJ, Tishler TA, et al. MRI evaluation of brain iron in earlier- and later-onset Parkinson’s disease and normal subjects. Magn Reson Imag. 1999; 17: 213–22.32. Haacke EM, Makki M. Characterizing Iron Deposition in Multiple Sclerosis Lesions Using Susceptibility Weighted Imaging J Magn Reson Imaging 2009; 29(3):537-44.
33. Levine SM, Chakrabarty A. The role of iron in the pathogenesis of experimental allergic encephalomyelitis and multiple sclerosis. Ann N Y Acad 2004; 1012:252–66.
34. Liu S, Buch S, Chen Y, Choi HS, Dai Y, Habib C, et al. Susceptibility-weighted imaging: current status and future directions. NMR Biomed. 2017 Apr;30(4).