DIAGNOSTIC ROLE OF SUSCEPTIBILITY WEIGHTED IMAGING (SWI) IN DETECTING CEREBRAL MICROBLEEDS IN TRAUMATIC BRAIN INJURY

Abstract

In cases of traumatic brain injury (TBI), cerebral microbleeds (CMBs) are imperceptible hemorrhagic lesions that are often overlooked. These lesions may be prognostic in nature, and Susceptibility Weighted Imaging (SWI) provides increased sensitivity for identifying them. Objective: to analyze SWI's diagnostic efficacy and determine the presence, distribution, and clinical correlations of CMBs in TBI patients. Methods: MRI brain scans with SWI sequences were performed on eighty-two TBI patients. Individuals with full clinical records, regardless of age or gender, were included; those with metallic implants, tumors, previous brain surgery, or neurological problems were not. The presence, quantity, size, and location of CMBs were assessed separately by two radiologists. Clinical information was documented, including the severity and symptoms of TBI. Microbleeds, clinical factors, and TBI severity were evaluated statistically, and Cohen's κ was used to estimate inter-rater reliability. Results: Males made up 56.1% of the group, and moderate TBI was most prevalent (54.9%). 48.8% of patients had CMBs, primarily in the deep brain (16.7%), cortical (20.8%), and subcortical (33.3%) regions. The most common clinical symptoms were headache (63.4%) and loss of consciousness (58.5%), however there was no significant relationship between the existence of microbleed and the type of symptom or the severity of TBI (χ²(2) = 0.53, p = 0.77). With 94% sensitivity, 91% specificity, 92% positive predictive value, 93% negative predictive value, and 93% overall accuracy, SWI showed excellent diagnostic performance. There was significant inter-rater agreement (Cohen's κ = 0.86). All TBI severity levels, even mild instances, experienced microbleeds. Conclusion: SWI is a highly sensitive and reliable modality for detecting CMBs in TBI patients, including those with mild injuries that may be missed on conventional imaging. Regularly incorporating SWI into TBI imaging methods can enhance patient care, risk assessment, and early detection, thereby influencing long-term prognosis evaluations.