Multiple Susceptibility Artifact Lesions

Case A: Familial cavernous malformations: A patient with a familial history presents with multiple foci of susceptibility, the largest of which (pons, left corona radiata) demonstrate a typical “popcorn” appearance with central heterogeneity and circumferential complete rings of hypointense signal on T2-weighted images, without mass effect or edema.

Case B: Hypertension: Multiple cerebral microhemorrhages involving the deep gray nuclei, brainstem, and cerebellum in a patient with a history of hypertension. There also are periventricular T2 hyperintensity and bilateral deep gray nuclei lacunes.

Case C: Diffuse axonal injury: A patient with a history of trauma with microhemorrhages involving the cerebral gray/white matter junctions, corpus callosum, and the left middle cerebellar peduncle. There is restricted diffusion in the genu and splenium of the corpus callosum as well as the right corona radiata.

Case D: Hemorrhagic metastases (breast cancer): A patient with a history of malignancy with prominent foci of susceptibility, T1 hyperintensity, associated enhancement, and surrounding vasogenic edema.

Case E: Amyloid angiopathy: A patient older than 60 years with multiple cerebral microhemorrhages in a peripheral pattern (cortical/subcortical distribution) sparing the deep white matter, basal ganglia, brainstem, and cerebellum. There is also moderate periventricular white matter T2 hyperintensity.