The Role of Susceptibility Weighted Imaging (SWI) in Evaluation of Acute Stroke

Abstract

Background and Objectives: SWI provides information about blood oxygenation levels in intracranial vessels. Prior reports have shown that SWI focusing on venous drainage can provide noninvasive information about the degree of brain perfusion in arterialischemic stroke. We aimed to evaluate the influence of the SWI venous signal pattern in predicting stroke evolution. Materials and Methods: a semiquantitative analysis of venous signal intensity on SWI and diffusion characteristics on DTI was performed in 2o adult patients with acute stroke of MCA vascular territories. The mismatch between areas with SWI-hypointense venous signal and restricted diffusion was correlated with stroke progression on follow-up. Results: we included 2O patients with a confirmed diagnosis of arterial ischemic stroke. Follow-up images were available for. MCA stroke progression on follow-up was observed in 11/12 patient with DWI-SWI mismatch. Initial SWI hypointense venous signal and areas of restricted diffusion on DTI. This mismatch showed a statistically significant association (P _ 0.00188) for infarct progression. Conclusion: SWI-DWI mismatch predicts stroke progression in arterial ischemic stroke.