 A very good morning to one and all. My name is Dr. Faiz Zubayr Sheikh. I'm a post graduate residence to render the Department of Radio Diagnosis and MMI MSR Mulana, located in the city of Ambala, state of Haryana. My topic for presentation today is magnetic susceptibility-weighted imaging, that is SWI, and it's role in the assessment of various brain lesions. SWI is a new means to enhance contrast in the MR imaging. It offers information about deoxygenated blood, hemocydrin, ferritin, calcium. SWI-based venography uses the fact that paramagnetic deoxyemoglobin in the wings causes a shift in the resonance frequency between the venous vein channel and the surrounding tissue. It has a diagnosing stroke, trauma, vascular malformations, tumors, aging, and multiple sclerosis. This technique exploits the susceptibility differences in tissues such as the signal to the substances. With different susceptibilities, then the neighboring tissues such as venous blood or hemorrhage will become out of phase. It offers potential for better diagnosis, thus better patient management and prognosis. It has better follow-up for longitudinal studies to be involved in clinical research. 50 patients were studied with known or suspected brain lesions. The MRI machine used over the year was the Philips 1.5-s scanner MRI machine. The routine sections which were taken were T1-vided imaging, T2-vided imaging, T2-flat, contrast T1-vided imaging, and SWI. CT images were also acquired whenever possible. MRI sequence protocol, as mentioned, first is trauma. So we have an image A. This is an entity image in which we have bilateral, frontal, subcortical, and right-basal ganglia, hyperdense hemorrhagic profile with surrounding edema. Also seen as left parietotemporal subdural hemorrhage. In image B, which is the T1-vided image, we see hyperintense right-basal ganglia hemorrhagic lesion with surrounding hyperintense edema and left subdural hemorrhage. In image C, which is the DWI, reviews hyperintense corded lesions. In image D, ADC map demonstrates restricted diffusion between the lesion. In image E, which is an SWI image, that is, the SWI MIP image clearly depicts multiple frontal corticals and subcortical and also right-basal ganglia micro-hemorrhages, which is better visualized than CT, and T1-vided MR image. Image F is a phase contrast SWI image in which we see hemorrhagic lesion showing a bright or positive shift effect on phase image due to paraphernalia susceptibility effect. Next up is with stroke. An 87-year-old woman with right-postural cerebral artery in path. Image A, which is the DWI, shows right temporal or symmetrical PCA type in path. Image B is SWI micro-image, which shows right PCA P1 segment susceptibility sign. Image C is coronal CT lip angiography image, which confirms right proximal PCA occlusion. Next case is a 38-year-old man complaining of right-sided weakness. Image A, which is the DWI image, shows hyperintense lesion. In the left temporal insular region, image B, which is an ADC map, reveals restricted diffusion in the corresponding area, indicating a left MCA acute in path. Image C is an SWI image, which shows prominent cortical veins within the left MCA artery, reflecting a relatively increased deoxyhemoglobin concentration in the ischemic region. Intensive kevanoma was seen in the left halibut. Next study involves the chronic microbleeds. So we have two comparisons, comparative images over here. One is image A, which is SWI, and image B is GW, which is T2 imaging. So in image A, we see many microbleeds in the deep-basin ganglia and sub-particle white mentor, which is better visualized in image A than compared to image B. Again, over here, it's a separability weighted imaging show mixed pattern of A, that is in image A, deep thalamic, and in image B, low bar, near the context, cerebral microbleeds. Next stop is the tumors. A 48-year-old man with a history of glioblastoma multi-form GBM. So in image A, we have FSC T2 weighted image, a heterogeneous high-signal intensity in the right trontolob mass, with surrounding hyperintense implicit adiba is seen. The tumor is compressing, the right atrial ventricle, and leading to right to left shift. In image B, we have axial SE T1 contrast in our image, in which we see tumor shows heterogeneous contrast enhancement. In image C, we have SWMF image, which is with microhemorrhages, in the periphery of the tumor, indicating a high-grade neoplasm. Next case is a 55-year-old man, or 55-year-old woman, complaining of left-sided tinnitus. In image A, we have axial FSC T2 weighted image, a heterogeneous high-signal intensity mass, in the left CP angle system is seen. In image B, we have only axial SE T1 weighted contrast enhanced image, heterogeneous contrast enhancement is seen. In image C, we have SWR-magnetic imagery, with punctate hyperintense foci, within the mass, indicating a probable acoustic sonar mass. Image D is SWR-phase image, conforms to the right microhemorrhages, in the causing of paramagnetic effect. CNS vascular malformations. So here we have two different cases, image A B and image CD. So in image A B, we have a 21-year-old man, with left trontolabialis malformation. In image A, we have axial FSC T2 weighted image, a left trontolabialis malformation is seen, with typical popcorn appearance, surrounded by a thick hemocidal rim. Image B, which is SWR, shows prominent blooming artifacts, due to paramagnetic effect. Image C and D is a 39-year-old man, with left cerebellar trontolabialis malformation. In image C, what we see is this is a axial T2 weighted image, which clearly depicts the femoral malformation, consisting of a high-signal intensity core, and a peripheral low-signal intensity hemocidalis. Image D is on SWR, the region is more conspicuous. Next case is 65-year-old man, which is clearly discovered, capital telangactasia in the ponds. Image A is axial FSC T2 weighted image, which was a hyper-intense lesion, located in the central ponds. Image B is axial contrast inhaled, C1 weighted imagery means, very little contrast inhaled points in the lesion. Image C is SWR image, which remonstrates a markedly hypo-indense lesion. In the ponds, indicating a capital telangactasia, based on its location and size. Next is extra-axial hemorrhages. So we have image A, which is an NCC image, which shows subarachnoin hemorrhage. In image B, we have the SWR image, which we see hemorrhage within the cell chi of the cell, marked by black arrows, in agreement with the result of CT, one of which is the shopper contrast. Next study involves neurocystic circumstances. So we have six images. Image A is a NCC T-scan, and we see a capsified lesion in the right corner nucleus. The lesion is hypo-intense on T2 weighted image in image B, and 3D MPH, which is the image C. This lesion shows increased susceptibility on LWI, which is an image D. This is an eccentric area of positive phase shift, suggesting the presence of paramagnetic disruptions, like iron within it, corresponding to the Scholex. There is subtle post-contrast rem enhancement, which is seen in image F. Presidential Scholex, within the capsified lesion in the CT, is pathogenomic for capsified nodular stage of NCC. So here is the tabular representation, indicating the entire study, in which we have 50 patients. So the comparison is made between the conventional MRI and the SWI. So SWI had a more role in all the mentioned cases over here, as compared to the conventional MRI. The pitfalls is basal ganglion cathartication for magnetic susceptibility. Under estimation of intertrival cathartication size, some susceptibility differences due to variations of blood oxygen levels, there could be mimickers, bone air interface artifacts, acute and chronic hemorrhages. Based on the applications of SWI, it provides additional information as compared with conventional MRI imaging sequences used for DAI, cerebral amyloid angiopathy, cadacillus, cerebral paratympolism, surgery of syndrome, multiple sclerosis, calcification from the hemorrhage, Parkinson's disease, hand avoidance, path syndrome. So conclusion, it has high spatial resolution and excellent contrast noise ratio and should be included into brain protocol. It is useful and highly sensitive for detection of intra and extra vascular blood degradation products, such as V-oxyemoglobin, methemoglobin, hemocidin, and for the detection of deposits of calcium and iron in the brain. As we most stated, it is very helpful to treat micro and macro hemorrhages and delineating cerebral microvascularation and low-flow vascular malformations as differentiating calcium and hemorrhage in the brain. So here are the references. Thank you very much. May you have a nice day.