Quantitative susceptibility-weighted imaging in presence of strong susceptibility sources: Application to hemorrhage

Ashmita De; Hongfu Sun; Derek J Emery; Kenneth S Butcher; Alan H Wilman

doi:10.1016/j.mri.2022.06.010

Quantitative susceptibility-weighted imaging in presence of strong susceptibility sources: Application to hemorrhage

Magn Reson Imaging. 2022 Oct:92:224-231. doi: 10.1016/j.mri.2022.06.010. Epub 2022 Jun 27.

Authors

Ashmita De¹, Hongfu Sun², Derek J Emery³, Kenneth S Butcher⁴, Alan H Wilman²

Affiliations

¹ Department of Biomedical Engineering, University of Alberta, Edmonton, Canada. Electronic address: ashmita@ualberta.ca.
² Department of Biomedical Engineering, University of Alberta, Edmonton, Canada.
³ Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, Canada.
⁴ Division of Neurology, Department of Medicine, University of Alberta, Edmonton, Canada.

PMID: 35772582
DOI: 10.1016/j.mri.2022.06.010

Abstract

Purpose: To optimize quantitative susceptibility-weighted imaging also known as true susceptibility-weighted imaging (tSWI) for strong susceptibility sources like hemorrhage and compare to standard susceptibility-weighted imaging (SWI) and quantitative susceptibility mapping (QSM).

Methods: Ten patients with known intracerebral hemorrhage (ICH) were scanned using a 3D SWI sequence. The magnitude and phase images were utilized to compute QSM, tSWI and SWI images. tSWI parameters including the upper threshold for creating susceptibility-weighted masks and the multiplication factor were optimized for hemorrhage depiction. Combined tSWI was also computed with independent optimized parameters for both veins and hemorrhagic regions. tSWI results were compared to SWI and QSM utilizing region-of-interest measurements, Pearson's correlation and Kruskal-Wallis test.

Results: Fifteen hemorrhages were found, with mean susceptibility 0.81 ± 0.37 ppm. Unlike SWI which utilizes a phase mask, tSWI uses a mask computed from QSM. In tSWI, the weighted mask required an extended upper threshold far beyond the standard level for more effective visualization of hemorrhage texture. The upper threshold was set to the mean maximum susceptibility in the hemorrhagic region (3.24 ppm) with a multiplication factor of 2. The blooming effect, seen in SWI, was observed to be larger in hemorrhages with higher susceptibility values (r = 0.78, p < 0.001) with reduced blooming on tSWI. On SWI, 4 out of 15 hemorrhages showed phase wrap artifacts in the hemorrhagic region and all patients showed some phase wraps in the air-tissue interface near the auditory and frontal sinuses. These phase wrap artifacts were absent on tSWI. In hemorrhagic regions, a higher correlation was observed between the actual susceptibility values and mean gray value for tSWI (r = -0.93, p < 0.001) than SWI (r = -0.87, p < 0.001).

Conclusion: In hemorrhage, tSWI minimizes both blooming effects and phase wrap artifacts observed in SWI. However, unlike SWI, tSWI requires an altered upper threshold for best hemorrhage depiction that greatly differs from the standard value. tSWI can be used as a complementary technique for visualizing hemorrhage along with SWI.

Keywords: Hemorrhage; Phase; QSM; SWI; tSWI.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Artifacts*
Cerebral Hemorrhage / diagnostic imaging
Humans
Magnetic Resonance Imaging* / methods
Veins

Grants and funding

PS 159568/CIHR/Canada