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Clinical significance of asymmetric hypointense signals in minimum intensity projections of brain magnetic resonance imaging in children with primary headache

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

This study aimed to observe the changes of venous continuity using the susceptibility weighted imaging-minimum intensity projection (SWI-MinIP) images in children with primary headache.

Methods

The headache types were classified following the International Headache Society’s diagnostic criteria. Patients with secondary headaches were excluded. The presence of asymmetric vasculature in SWI-MinIP images was visually assessed. Moreover, the relationship between headache patterns and asymmetric hypointense signals was analyzed.

Results

In this single-center, retrospective study from 2016 to 2020, among 251 cases of primary headache (male/female, 108/143; mean age, 11.4 ± 4.0 years), 137 (54.6%), 75 (29.9%), and 39 (15.5%) patients had migraine, tension-type headache, and other primary headaches, respectively. On SWI-MinIP images, 14 (5.6%) patients showed an asymmetric venous pattern. All patients with SWI-MinIP asymmetry were included in the migraine group, accounting for 10.2% of patients with migraine. Five (35.7%) and nine (64.3%) patients were included in the aura and non-aura groups, respectively, without a significant difference in the frequency of asymmetric hypointense signals between the two groups (p = 0.325). All 14 patients with asymmetric hypervascularity had brain MRI within 12 h of headache onset. Ten (71.4%) of the 14 patients showed consistency between the laterality of headache and the hemisphere of predominant vascularity in SWI-MinIP.

Conclusion

Patients with migraine had increased cerebral venous perfusion in the most involved region of the headache on the SWI-MinIP view on a 3.0 T scanner, which can be used as a qualitative indicator with low sensitivity and high specificity for the diagnosis of primary headache in the acute phase (< 12 h).

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Acknowledgements

None.

Funding

The authors (Han MJ, Park SY, Hwang SB, and Kim SJ) declare that no party has direct interests in the results of this study and that no organization with which the authors are associated has offered or will confer a benefit to them concerning the results of this study.

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Authors and Affiliations

  1. Department of Pediatrics, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea

    Min Jeong Han, So Yeon Park & Sun Jun Kim

  2. Research Institute of Clinical Medicine of Jeonbuk National University, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea

    Min Jeong Han, Seungbae Hwang & Sun Jun Kim

  3. Biomedical Research Institute of Jeonbuk National University Hospital, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea

    Min Jeong Han, Seungbae Hwang & Sun Jun Kim

  4. Department of Radiology, Jeonbuk National University Medical School, Jeonbuk, 54907, Korea

    Seungbae Hwang

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  1. Min Jeong Han
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Correspondence to Sun Jun Kim.

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The study was approved by the Institutional Review Board of Jeonbuk National University Hospital (IRB no. 2020–03-032).

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Han, M.J., Park, S.Y., Hwang, S. et al. Clinical significance of asymmetric hypointense signals in minimum intensity projections of brain magnetic resonance imaging in children with primary headache. Neuroradiology 65, 415–422 (2023). https://doi.org/10.1007/s00234-022-03076-8

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