Should susceptibility-weighted imaging be included in the basic protocol for magnetic resonance imaging of the brain?

Objective: To analyze the clinical impact of routine acquisition of susceptibility-weighted imaging (SWI) in magnetic resonance imaging (MRI) studies of the brain.

Material and methods: This prospective observational study included all patients undergoing brain MRI including SWI during a 6-month period. Patients were divided into two groups based on the clinical information provided: Group 1 comprised patients in whom SWI acquisition formed part of the brain MRI protocol, and Group comprised patients who underwent SWI without these sequences being included in the protocol. We recorded patients' age, sex, and risk factors (hypertension, history of brain trauma or intracranial vascular malformations). We analyzed the SWI findings, whether these findings were visible on the other sequences, and whether identifying these findings resulted in substantial changes to the radiological report.

Results: There were 62 patients in Group 1 and 79 in Group 2. The groups were similar in age and risk factors. SWI findings resulted in substantial changes to the radiological report in 34% of the patients in Group 1 and in 14% of those in Group 2; this difference was statistically significant.

Conclusion: SWI can help radiologists detect findings not seen on conventional brain MRI that sometimes result in substantial changes to the radiological report.