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The authors evaluated 198 consecutive patients with acute ischemic stroke with large-vessel occlusion who underwent noncontrast CT immediately after mechanical thrombectomy between January 2014 and September 2018. The metallic hyperdensity sign was defined as a nonpetechial intracerebral hyperdense lesion in the basal ganglia and a maximum CT density of >90 HU. The metallic hyperdensity sign was found in 59 (29.7%) patients, and 51 (25.7%) patients had parenchymal hemorrhage at 24 hours. Patients with the metallic hyperdensity sign are more likely to have parenchymal hemorrhage than those without it.

The authors analyzed the accuracy of gadolinium SWI for detecting the imaging evidence of active inflammation on MS plaques when a BBB dysfunction was demonstrated by a focal gadolinium-enhanced lesion and compared this technique with gadolinium-enhanced T1 spin-echo and T1 spin-echo with magnetization transfer contrast sequences. Differences in BBB dysfunction were evident in the 103 patients among gadolinium SWI, gadolinium T1 spin-echo, and gadolinium T1 magnetization transfer contrast. Gadolinium T1 magnetization transfer contrast demonstrated the highest number of active demyelinating plaques. Gadolinium SWI was highly correlated with gadolinium T1 magnetization transfer contrast in depicting acute demyelinating plaques and these techniques provided better performance compared with gadolinium T1 spin-echo.