Reliability of magnetic susceptibility weighted imaging in detection of cerebral microbleeds in stroke patients

Abstract

Objective: We investigated the reliability of susceptibility weighted imaging (SWI) in detecting cerebral microbleeds in stroke patients which predicts future recurrence and judges thrombolytic drugs. Methods: A total of 124 patients referred from stroke unit underwent conventional MRI and SWI. Two observers reviewed twice the SWI separately to identify presence, anatomical location and count of cerebral microbleeds. Inter and intraobserver agreement were calculated using Kappa statistics. Results: In SWI, intraobserver agreement for presence of CMBs in any brain location was almost perfect for both observers (K = 0.86, p < 0.01, 95% CI = 0.83–0.89) (K = 0.94, p < 0.01, 95% CI = 0.92–0.96), the interobserver agreement was almost perfect for first and second times (k = 0.95, p < 0.01, 95% CI = 0.94–0.96), (k = 0.84, p < 0.01, 95% CI = 0.8–0.89). Intraobserver agreement was almost perfect for the identified CMBs in each of the three main brain locations : lobar (k = 0.9, p < 0.01 95% CI = 0.8–1), deep (k = 0.81 p < 0.01, 95% CI = 0.71–0.91) and infratentorial (k = 0.95 p < 0.01, 95% CI = 0.9–1). Conclusion: SWI is an important reliable technique allows accurate detection of CMBs occurring in association with hemorrhage in acute and chronic stroke and should be included in the protocols for assessment of stroke to help in choice of proper treatment and prediction of future attacks