Background Computed tomography （CT） is better than routine magnetic resonance imaging （MRI） in detecting intracranial calcification. This study aimed to assess the value of MR susceptibility weighted imaging （SWI） in the detection and differentiation of intracranial calcification and hemorrhage. Methods Enrolled in this study were 35 patients including 13 cases of calcification demonstrated by CT and 22 cases of intracerebral hemorrhage. MR sequences used in all the subjects included axial T1WI, T2WI and SWI. The phase shift （PS） of calcification and hemorrhage on SWI was calculated and their signal features on corrected phase images were compared. The sensitivity of T1WI, T2WI and SWI in detecting intracranial calcification and hemorrhage was analyzed statistically. Results The detection rate of SWI for cranial calcification was 98.2%, significantly higher than that of T1WI and T2WI. It was not significantly different from that of CT （P 〉0.05）. There were 49 hemorrhagic lesions at different stages detected on SWI, 30 on T2WI and 18 on T1WI. The average PS of calcification and hemorrhage was ＋0.734±0.073 and -0.112±0.032 respectively （P 〈0.05）. The PS of calcification was positive and presented as a high signal or the mixed signal dominated by a high signal on the corrected phase images, whereas the PS of hemorrhage was negative and presented as a low signal or the mixed signal dominated by a low signal.Conclusions SWI can accurately demonstrate intracranial calcification, not dependant on CT. Being more sensitive than routine MRI in detecting micro-hemorrhage, SWI may play an important role in differentiating cerebral diseases associated with calcification or hemorrhage.
ZHU Wen-zhen QI Jian-pin ZHAN Chuan-jia SHU Hong-ge ZHANG Lin WANG Cheng-yuan XIA Li-ming HU Jun-wu FENG Ding-yi
Brain iron deposition has been proposed to play an important role in the pathophysiology of Alzheimer disease（AD）.The aim of this study was to investigate the correlation of brain iron accumulation with the severity of cognitive impairment in patients with AD by using quantitative MR relaxation rate R2＇ measurements.Fifteen patients with AD,15 age-and sex-matched healthy controls,and 30 healthy volunteers underwent 1.5T MR multi-echo T2 mapping and T2＊ mapping for the measurement of transverse relaxation rate R2＇（R2＇=R2＊-R2）.We statistically analyzed the R2＇ and iron concentrations of bilateral hippocampus（HP）,parietal cortex（PC）,frontal white matter（FWM）,putamen（PU）,caudate nucleus（CN）,thalamus（TH）,red nucleus（RN）,substantia nigra（SN）,and dentate nucleus（DN） of the cerebellum for the correlation with the severity of dementia.Two-tailed t-test,Student-Newman-Keuls test（ANOVA） and linear correlation test were used for statistical analysis.In 30 healthy volunteers,the R2＇ values of bilateral SN,RN,PU,CN,globus pallidus（GP）,TH,and FWM were measured.The correlation with the postmortem iron concentration in normal adults was analyzed in order to establish a formula on the relationship between regional R2＇ and brain iron concentration.The iron concentration of regions of interest（ROI） in AD patients and controls was calculated by this formula and its correlation with the severity of AD was analyzed.Regional R2＇ was positively correlated with regional brain iron concentration in normal adults（r=0.977,P0.01）.Iron concentrations in bilateral HP,PC,PU,CN,and DN of patients with AD were significantly higher than those of the controls（P0.05）;Moreover,the brain iron concentrations,especially in parietal cortex and hippocampus at the early stage of AD,were positively correlated with the severity of patients＇ cognitive impairment（P0.05）.The higher the R2＇ and iron concentrations were,the more severe the cognitive impairment was.Regional R2
