Susceptibility-Based Differentiation of Intracranial Calcification and Hemorrhage in Pediatric Patients

J Child Neurol. 2015 Jul;30(8):1029-36. doi: 10.1177/0883073814552439. Epub 2014 Oct 27.

Abstract

Differential diagnosis of intracranial hemorrhage versus calcification on conventional magnetic resonance images (MRIs) is often challenging. Although computed tomography (CT) confirms calcification, phase information obtained during susceptibility-weighted imaging can be useful in distinguishing between 2 pathologies. Fourteen patients previously diagnosed to have hemorrhage or calcification with imaging were included in the study retrospectively. Phase shift values of hemorrhage and calcification were compared by using Student t test. The pathologies identified were tuberous sclerosis, Sturge-Weber syndrome, craniopharyngioma, congenital cytomegalovirus, subependymal hemorrhages, and hemorrhagic microembolic infarction. Calcifications appeared hypointense whereas hemorrhages were hyperintense on phase maps (left-handed magnetic resonance system). Statistical comparison of phase shift values yielded significant difference between hemorrhage versus calcification (P < .01). Phase maps were found to offer valuable data to differentiate 2 pathologies when used complementary to conventional magnetic resonance images. Considering the relatively higher risks of radiation exposure in children, susceptibility-weighted imaging with phase maps may help to waive radiation exposure from CT.

Keywords: calcification; intracranial hemorrhage; phase image; susceptibility-weighted imaging.

MeSH terms

  • Adolescent
  • Calcinosis / diagnosis*
  • Child
  • Child, Preschool
  • Diagnosis, Differential*
  • Disease Susceptibility
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intracranial Hemorrhages / diagnosis*
  • Magnetic Resonance Imaging
  • Male
  • Retrospective Studies
  • Tomography, X-Ray Computed