CASE REPORT Imaging Cerebral Amyloid Angiopathy with Susceptibility-Weighted Imaging

SUMMARY: Gradient-echo (GE) imaging is recognized as a means to detect hemorrhagic changes in cerebral amyloid angiopathy (CAA). However, almost 25 % of patients with CAA do not show micro-hemorrhages on T2 * GE imaging. We applied a new imaging method, susceptibility weighted imaging (SWI), to evaluate the presence of microhemorrhages. In a suspected case of CAA, where cognitive effects are also present, we show that SWI is much more sensitive in detecting microhemorrhages than conventional methods. Susceptibility-weighted imaging (SWI) is a new imagingmethod that maximizes sensitivity to magnetic suscepti-bility effects1,2 and is clinically useful for evaluating trauma and vascular malformations.3,4 However, the role of SWI in other neuropathology has not been extensively evaluated. SWI is more sensitive than conventional gradient-echo (GE) tech-niques for the detection of blood products.4 Because GE im-aging is a well-recognized method of detecting changes indic-ative of cerebral amyloid angiopathy (CAA),5-8 SWI should be successful as well. This is the first reported evaluation of SW