C A S E R E P O R T Usefulness of magnetic resonance imaging with SWI sequence (susceptibility-weighted imaging) in diagnosing cerebral hemosiderosis – case report Elżbieta Jurkiewicz1, Iwona Pakuła-Kościesza1, Sławomir Barszcz2, Katarzyna Nowak1, Ewa Święszkowska3, Marcin Roszkowski2 1 MRI Laboratory, Department of Diagnostic Imaging, The Children’s Memorial Health Institute, Warsaw, Poland 2 Department of Neurosurgery, The Children’s Memorial Health Institute, Warsaw, Poland 3 Department of Oncology, The Children’s Memorial Health Institute, Warsaw, Poland Author’s address: Elżbieta Jurkiewicz, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20 Str., 04-730 Warsw, Poland, e-mail: e-jurkiewicz@o2.pl Summary The purpose of this study was to determine whether the SWI sequence may improve the MRI evaluation of hemosiderin deposits in the brain. We report a case of a 7-year-old girl after a total resection of a large tumor mass (ependymoma G II) located in the left hemisphere. Late complication of surgery was hemosiderosis of the brain diagnosed with SWI sequence. SWI sequence is very sensitive in diagnosing hemosiderin deposits. It allowed us to recognize cerebral hemosiderosis in this case. We suggest to include this sequence in routine MRI examinations of the brain, especially in cases of potential and suspected intracranial bleeding magnetic resonance imaging • SWI (susceptibility-weighted imaging) • hemosiderosis • hemispherectomy • children Background: Case Report: Conclusions: Key words: PDF file: http://www.polradiol.com/fulltxt.php?ICID=881148 Signature: © Pol J Radiol, 2010; 75(3): 47-50 Received: 2010.04.09 Accepted: 2010.05.31 Background SWI sequence, i.e. imaging depending on magnetic suscep- tibility, is a relatively new sequence used in MRI examina- tions. It is becoming a routine practice due to its usefulness in diagnosing diseases accompanied by iron deposition and calcifications [1]. SWI is especially useful in diagnosing brain areas that underwent even slight disturbances of the magnetic field homogeneity. One of the causes of changes in the local homogeneity of the field is the presence of blood/hemosiderin inside the brain or pericerebrally. Due to that fact, SWI sequence reveals a high sensitivity in diagnosing microcalcifications, several times higher than the one presented by other, previ- ously used, T2-weighted gradient-echo sequences. We present a case of a seven-year-old girl subjected to a total resection of a large tumor mass of the left hemisphere (ependymoma G II) who developed (as a late postoperative complication) cerebral hemosiderosis diagnosed with the use of SWI sequence. Case Report The seven-year-old girl was admitted to the Neurosurgical Department at the beginning of July 2007 due to a CT- and MRI-diagnosed large tumor mass of the left posterior hemi- sphere with a mass effect, dislocation of the midline struc- tures and an active external hydrocephalus. The tumor was located in the parietal-temporal-occipital region within the trigone of the left lateral ventricle of the brain. The main clinical symptoms were the increased intracranial pressure and macrocrania. An extensive craniotomy of the left pari- etal-temporal-occipital led to a total tumor resection with an opening of the left lateral ventricle of the brain. 47