Diagnosis of intracranial calcification and hemorrhage in pediatric patients: Comparison of quantitative susceptibility mapping and phase images of susceptibility-weighted imaging

Abstract

Purpose: To prospectively compare the diagnostic capabilities of quantitative susceptibility mapping (QSM) with those of phase images of susceptibility-weighted imaging (SWI) in the detection and differentiation of intracranial calcification and hemorrhage in pediatric patients.

Method: Sixteen pediatric patients (9 girls, 7 boys) with a mean age of 9.4±6.3 (SD) years (range, 6 days-15 years) were included. Fifty-nine calcifications and 31 hemorrhages were detected. Sensitivities and specificities of the two magnetic resonance (MR) imaging techniques were calculated and compared using McNemar test.

Results: QSM had a sensitivity of 84.7% and specificity of 100% for the detection of calcification. SWI phase images had a sensitivity of 49.1% and specificity of 100%. For the detection of hemorrhage, QSM had a sensitivity of 90.3% and a specificity of 98.3% whereas SWI phase images yielded a sensitivity of 64.5% and specificity of 96.6%. Overall, QSM displayed significantly better sensitivity than SWI phase images in identification of calcification and hemorrhage (P<0.05).

Conclusion: QSM is more reliable than SWI phase images in the identification of intracranial calcification and hemorrhage in pediatric patients using MR imaging.

Keywords: Brain; Calcification; Hemorrhage; Quantitative susceptibility mapping; Susceptibility-weighted imaging.