Differentiating Perihemorrhagic Infarct from Susceptibility Artifact on DWI Images
Bammer R, Lansberg M, Clayton D, Albers G, Nagle S
On DWI imaging of parenchymal brain hemorrhage, a high-intensity rim often surrounds the hemorrhage. Differentiating whether this is due to infarction or susceptibility artifact can be difficult. A simple method, based upon the anisotropy of the susceptibility artifact, can help differentiate between these etiologies. In a clinical series of 55 stroke patients, four of which had parenchymal hemorrhage with hyperintense rim, the use of two DWI sequences with swapped phase- and frequency-encoded directions clearly demonstrated that this was due to artifact rather than infarct. A single DWI sequence was insufficient to make this differentiation with confidence.