STUDY OF SIGNIFICANCE OF PHASE MASK IMAGE IN ACUTE STROKE PATIENTS

Background: Phase images contains information regarding local susceptibility changes between the tissues, which can help measure the iron and other content which changes the local field. Typically, this information is ignored before looking at console. Susceptibility weighted imaging (SWI) is a magnetic resonance (MR) technique detects an early hemorrhagic transformation within the infarct to provide insight into cerebral hemodynamics following the stroke. Objective: Significance of “phase mask imaging in differentiation of hemorrhage and calcifications†in acute stroke patients. Methods: An observational non-interventional study carried out on 100 patients with stroke and headache symptoms. MRI Brain Stroke Profile with FLAIR, DWI, ADC, SWAN, and Phase mask sequences, done on 3T GE MRI scanner. Results: All patients underwent MRI study with SWI sequence. Of 183 cases, 33%(n=60) patients had microbleeds, 5%(n=10) patients had granulomas, 32%(n=58) patients had arterial thrombus with infarct, 11%(n=20) patients had falx calcifications, 11%(n=20) patients had intraparenchymal haemorrhage, and 8%(n=15) patients had infarcts with haemorrhagic transformation. The sensitivity of phase imaging in the detection of calcification was 90%. Conclusion: Phase mask imaging plays an important role to detect intracranial calcifications and chronic microbleeds. Phase mask imaging acts as a supplement tool in acute stroke patients, which guides further management

Evaluation of Vascular Malformations on SWI in Patients Presented with Acute Stroke in 3T MRI

Background: Susceptibility-weighted imaging (SWI) had high spatial resolution 3D gradient-echo MRI sequence with phase post-processing that accentuates the paramagnetic properties of blood products.Aim: Significance of SWI sequence in detecting occult vascular lesions in patients with acute stroke.Method: A prospective study of 75 patients done in the department of Radio-diagnosis at tertiary care centre. Patients who were having symptoms of stroke and suspected vascular malformations of the brain were advised MRI Brain. Stroke Profile with SWAN, FLAIR, DWI & ADC done on 3T MR machine. SWI images were retrospectively examined by 2 independent radiologists. Their findings were then compared to study the efficacy of SWI in better detection and characterization of lesions.Results: Of 75 cases, 61 had microbleeds, 9 patients had cavernomas, venous angiomas in 4 patients and Arterio-venous malformation in one patient. SWI was highly sensitive and specific towards the detection of vascular malformations of the brain. Conclusion: SWI images are fast sequences requiring not more than a total scan time of about 3 minutes. Inclusion of this sequence as a part of brain pathology can play an important role in diagnosing different brain lesions without missing hemorrhagic lesions thus avoiding inappropriate therapeutics

Anatomical variations of posterior inferior cerebellar artery (PICA) on digital subtraction angiography (DSA)

Introduction: The posterior inferior cerebellar artery (PICA) often exhibits anatomical variations at the craniovertebral junction. Few studies investigated variations of the posterior inferior cerebellar artery, and the prevalence of other variations has not been reported. The study aimed to identify variations of the posterior inferior cerebral artery using cerebral Digital Subtraction Angiography (DSA). Method: 50 patients underwent 64-slice cerebral Digital Subtraction Angiography. Four types of variations were observed. Results: Out of a total of 50 patients, 23 (46%) were males and 27 (54%) females (all age groups). Our study has shown the utility of the 2 sequences - fluoroscopy and cine. All 2 sequences have their significance in evaluating anatomical variations in PICA. Only 20% of the 50 patients had all the posterior inferior cerebellar artery without anatomical variations. Anatomic variations commonly involve the distal segment of the vertebral artery (VA). Most of them are seen arising from the C1, C2, and both C1 and C2 origins. Anatomic variations involve arising from the C1 origin in 9 patients, C2 origin in 11 patients, C1 & C2 origin in 8 patients, and other variations observed in 12 patients. Conclusion: Variations of the posterior inferior cerebellar artery can be easily evaluated by cerebral Digital Subtraction Angiography (CDSA). Recognizing and reporting them at cerebral CDSA may be clinically important. Surgeons should be mindful of this variation during operations