Prominent cerebral veins on susceptibility-weighted imaging (SWI) in pulmonary embolism
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Clinical applications of susceptibility-weighted imaging (SWI) are increasing steadily. The aim of this study is to investigate the appearance of cerebral veins on SWI, which is very sensitive to the deoxyhaemoglobin level in vessels, in pulmonary embolism (PE).
The cranial SWI images of 19 patients with PE and 22 controls from September 2013 through March 2016 were retrospectively examined for the presence of prominent cerebral veins. MRI findings were correlated with blood oxygen levels.
12 of 19 patients with PE had hypoxemia and SWI images of 11 of these hypoxemic patients depicted prominent cerebral veins in the form of increased number, diameter, and elongation. The mean PaO2 and SaO2 in these patients were 48.5 ± 9.1 mmHg and 75.2 ± 8.0 %, respectively. There was a significant correlation between the presence of prominent veins on SWI and hypoxemia (p < 0.05). Of the 7 patients with normal blood oxygen pressure and saturation, 1 also showed an augmented appearance of cerebral veins on SWI.
In the presence of neurological symptoms suggestive of an intracranial pathology in patients with PE, a SWI added to the conventional MRI sequences may predict hypoxemia and exclude other intracranial pathologies.
• Patients with PE may exhibit nonspecific symptoms suggestive of an intracranial pathology.
• A cerebral venous prominence on SWI should raise the suspicion of hypoxia.
• SWI-mIP images intensify the appearance of veins and help distinguish other hypointensities.
KeywordsCerebral veins Hypoxemia Magnetic resonance imaging Pulmonary embolism Susceptibility-weighted imaging
The scientific guarantor of this publication is İbrahim Öztoprak, M.D., the head of the Department of Neuroradiology. The author of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. The author states that this work has not received any funding. No complex statistical methods were necessary for this paper. The author gratefully acknowledges Prof. İbrahim Öztoprak, M.D., for examining and evaluating MR images of the patients. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: retrospective, diagnostic or prognostic study, performed at one institution.
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