Investigation of effectiveness in determining hemorrhage, calcification and vascular anomalies in mri of child brain with adding susceptibility weighted imaging to conventional sequences

Objective: To investigate the efficacy of adding SWI sequence to conventional sequences in pediatric brain imaging to demonstrate calcific or hemorrhagic focus and abnormal venous structures, the usage areas of SWI in pediatric patients, the characteristics of SWI signals, sequence-specific artifacts and pitfalls. Materials and Methods: We retrospectively examine the images of pediatric patients who had pathologic signal foci on SWI sequence, with different pre-diagnosis MRI between 31.07.2017 and 22.01.2018. The foci are classified as homogeneous paramagnetic, primer paramagnetic, homogeneous diamagnetic and primer diamagnetic. Classification of lesions as calcification or hemorrhage was made in the context of CT and conventional MR images, medical history and clinical information including laboratory, pathology results. These foci have been investigated in conventional sequences. The focus higher than 100 HU on CT were accepted as gold standard for calcification. Descriptive statistical methods were used to classify the data. Chi-square test was used for agreement of conventional sequences and SWI. Chi-square test was used to compare the calcific foci observed on CT with conventional sequences and SWI. In the chi-square test, values below P <0.05 were considered to be statistically significant. Results: On SWI images 287 hypointense focuses were found. 135 of these foci were classified as diamagnetic or calcification, 149 as paramagnetic or hemorrhagic focus, and 13 as vascular anomaly. There are 6 signal changes on T1 WI, 11 signal on T2 WI and 7 signal on FLAIR the presence of foci that support calcification. Totaly 13 (approx. 9.6%) of the 135 diamagnetic focus were appeared in conventional sequences. There are 19 signal changes on T1 WI, 20 signal on T2 WI and 15 signal on FLAIR the presence of foci that support hemorrhagi. Twenty-five (approx. 16.7%) were selected on conventional sequences from a total of 149 signal changes. Only one of the vascular anomalies observed in thirteen patients on the conventional sequences was showed. There are 143 calcification focus on CT images. On SWI this was 135. Eight calcified foci could not be distinguished on SWI. A Chi-square test was used to compare the efficacy of SAG-added conventional sequences in detecting calcification with the efficacy of conventional sequences only in detecting calcification, and the p value was found to be 0,001. Conclusion: We observed that on SWI calcification or bleeding products have significant determined, because of the nature of hemorrhagi focus may be heterogeneous, involve some artifacts and have been shown heterogeneity is associated with the focal dimension of the foci and at the same time the sequence may be an important diagnostic tool in the diagnosis of venous anomalies.