Susceptibility-Weighted Imaging for Investigating the Effects of Drainage Veins in Cerebellar Infarction

Abstract

Background: The phase value of susceptibility weighted imaging (SWI) can quantitatively measure the content of deoxyhemoglobin in veins, thus facilitating understanding of the mechanisms of drainage veins in cerebellar infarction areas. Objectives: To explore the clinical application value of the drainage veins in acute cerebellar infarction. Patients and Methods: SWI was used to measure the phase value of the bilateral cerebellar hemispheres in 30 normal volunteers. In addition, phase values, expressed as Δφ, were analyzed in 18 patients with cerebellar infarction. The scanning sequences included SWI, arterial spin labeling, and diffusion weighted imaging. Results: The phase value of the infarct area was higher than that of the contralateral region (P = 0.001) and was negatively correlated with regional cerebral blood flow in the infarct area (r = -0.433, P = 0.027). However, analysis of the regional cerebral blood flow revealed a positive correlation with the regional apparent diffusion coefficient (r = 0.566, P = 0.003), but the phase value was not correlated with the regional apparent diffusion coefficient of the infarct area (r = -0.293, P = 0.146). Using receiver operating characteristic curve analysis, we determined the phase value of drainage veins and the regional cerebral blood flow value of the critical infarction in the ischemic penumbra of the cerebellar infarction to be 301 spin and 22.25 mL/(min·100g), respectively. Conclusion: Our study showed the relevance of using phase value and its correlation with cerebral blood flow to characterize cerebellar infarction. In addition, our findings suggested possible venous reverse perfusion and venous congestion in the infarcted cerebellar hemisphere, which may be critically related to the development of infarct. Furthermore, our approach using a combination of non-invasive imaging parameters including the susceptibility imaging, cerebral perfusion and diffusion may be helpful in the diagnosis and management of stroke involving the cerebellum.