• Krishna Teja Nerella Department of Radio-diagnosis, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra- 411018
  • Dileep Reddy Ayapaneni Department of Radio-diagnosis, Dr. D. Y. Patil Medical College, Hospital & Research Centre, Pune, Maharashtra- 411018



Intra-cranial lesions, hemorrhage, infarct, susceptibility weighted imaging, artifacts.


Background: Phase images contains information regarding local susceptibility changes between the tissues, which can help measure the iron and other content which changes the local field. Typically, this information is ignored before looking at console. Susceptibility weighted imaging (SWI) is a magnetic resonance (MR) technique detects an early hemorrhagic transformation within the infarct to provide insight into cerebral hemodynamics following the stroke.Objective: Significance of “phase mask imaging in differentiation of hemorrhage and calcifications†in acute stroke patients.Methods: An observational non-interventional study carried out on 100 patients with stroke and headache symptoms. MRI Brain Stroke Profile with FLAIR, DWI, ADC, SWAN, and Phase mask sequences, done on 3T GE MRI scanner.Results: All patients underwent MRI study with SWI sequence. Of 183 cases, 33%(n=60) patients had microbleeds, 5%(n=10) patients had granulomas, 32%(n=58) patients had arterial thrombus with infarct, 11%(n=20) patients had falx calcifications, 11%(n=20) patients had intraparenchymal haemorrhage, and 8%(n=15) patients had infarcts with haemorrhagic transformation. The sensitivity of phase imaging in the detection of calcification was 90%.Conclusion: Phase mask imaging plays an important role to detect intracranial calcifications and chronic microbleeds. Phase mask imaging acts as a supplement tool in acute stroke patients, which guides further management.


Halefoglu AM, Yousem DM. Susceptibility weighted imaging: Clinical applications and future directions. World journal of radiology; 2018 Apr 28;10(4):30. DOI: 10.4329/wjr.v10.i4.30

Gratz PP, El-Koussy M, Hsieh K, von Arx S, Mono ML, Heldner MR, Fischer U, Mattle HP, Zubler C, Schroth G, Gralla J. Preexisting cerebral microbleeds on susceptibility-weighted magnetic resonance imaging and post-thrombolysis bleeding risk in 392 patients. Stroke; 2014 Jun;45(6):1684-8.

DOI: 10.1161/STROKEAHA.114.004796

Barnes SR, Haacke EM. Susceptibility-weighted imaging: clinical angiographic applications. Magnetic resonance imaging clinics of North America. 2009 Feb 1;17(1):47-61. DOI: 10.1016/j.mric.2008.12.002

Deistung A, Barnes S, Ge Y, Reichenbach JR. Susceptibility weighted imaging at ultrahigh magnetic fields. Susceptibility weighted imaging in MRI. Basic Concepts and Clinical Applications.; 2011 Jan 24:329-49.DOI:

Haacke EM, Ye Y. The role of susceptibility weighted imaging in functional MRI. Neuroimage; 2012. 62:923–929. DOI: 10.1016/j.neuroimage.2012.01.020.

Robinson R.J, Bhuta S. Susceptibility-weighted imaging of the brain: Current utility and potential applications. Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging. 2011. 21:e189–e204. DOI: 10.1111/j.1552-6569.2010.00516.x

Azad R, Mittal P, Malhotra A, Gangrade S. Detection and differentiation of focal intracranial calcifications and chronic microbleeds using MRI. Journal of Clinical and Diagnostic Research; 2017 May;11(5):TC19.

DOI: 10.7860/JCDR/2017/24076.9846

Haacke EM, Reichenbach JR, Editors. Susceptibility weighted imaging in MRI: Basic concepts and clinical applications. John Wiley & Sons; 2014 Mar 25.

DOI: 10.1002/9780470905203

Mittal S, Wu Z, Neelavalli J, Haacke E. Susceptibility-weighted imaging: Technical aspects and clinical applications, part 2. American Journal of Neuroradiology; 2009;30:232–252.

DOI: 10.3174/ajnr.A1461

Claudot F, Alla F, Fresson J, Calvez T, Coudane H, Bonaïti-Pellié C. Ethics and observational studies in medical research: Various rules in a common framework. International journal of epidemiology. 2009 Aug 1;38(4):1104-8. DOI: 10.1093/ije/dyp164

Sahdev R, Rao A, Yadu N, Shukla Y. Role of susceptibility weighted imaging in characterization of intra-cranial lesions. Int J Med Res Rev; 2016. 4(11):2006-2014.

DOI: 10.17511/ijmrr.2016.i11.19

Tsivgoulis G, Zand R, Katsanos AH, et al. Risk of symptomatic intracerebral hemorrhage after intravenous thrombolysis in patients with acute ischemic stroke and high cerebral microbleed burden: A meta-analysis. JAMA neurology; 2016. Jun 1;73(6):675-83. DOI: 10.1001/jamaneurol.2016.0292

Tong KA, Ashwal S, Holshouser BA, et al. Diffuse axonal injury in children: Clinical correlation with hemorrhagic lesions. Ann Neurol; 2004. 56:36–50. DOI: 10.1002/ana.20123

Kızılgöz V, Avcı S, Sivrioğlu AK, et al. Evaluation of the canadian ct head rule for analyzing diagnostic accuracy in patients with minor head trauma. Malang Neurology Journal; 2019 Apr 29;5(2):68-75.

DOI: 10.21776/ub.mnj.2019.005.02.4

Sehgal V, Delproposto Z, Haddar D, et al. Susceptibility-weighted imaging to visualize blood products and improve tumor contrast in the study of brain masses. J Magn Reson Imaging ; 2006. 24:41–51. DOI: 10.1002/jmri.20598

New PFJ, Ojeman RG, Davis KR, et al. MR and CT of occult vascular malformations of the brain. Am J Neuroradiol; 1986. 7:771-779.

DOI: 10.2214/ajr.147.5.985

Marchal G, Bosmans H, Fraeyenhoven LV, Wilms G, Hecke PV, Plets C.A.L.B. Intracranial vascular lesions. Optimization and clinical evaluation of three-dimensional time-of-flight MR angiography. Radiology; 1990. 175:443-448.

DOI: 10.1148/radiology.175.2.2326471

Santhosh K, Kesavadas C, Thomas B, Gupta AK, Thamburaj K, Kapilamoorthy T. Susceptibility weighted imaging: A new tool in magnetic resonance imaging of stroke. Clin Radiol; 2009. 64(1):74–83. DOI: 10.1016/j.crad.2008.04.022

Zhu WZ, Qi JP, Zhan CJ, Shu HG, Zhang L, Wang CY, et al. Magnetic resonance susceptibility weighted imaging in detecting intracranial calcification and hemorrhage. Chin Med J; 2008. 121:2021–25.

Rachmawati D, Ningsih DK, Andarini S. Factors affecting the knowledge about stroke risks and early symptoms in emergency department East Java-Indonesia. Malang Neurology Journal; 2020. Jan 30;6(1):11-9.

DOI: 10.21776/ub.mnj.2020.006.01.3




How to Cite

Nerella, K. T., Ayapaneni, D. R., & Srikonda, S. (2021). STUDY OF SIGNIFICANCE OF PHASE MASK IMAGE IN ACUTE STROKE PATIENTS. Malang Neurology Journal, 8(1), 6–10.



Research Article