Clinical Applications of Susceptibility Weighted Imaging in Daily Practice: A Hospital Based Observational Study

Background: Susceptibility Weighted Imaging (SWI) is an advanced MRI technique that exploits tissue magnetic susceptibility differences to provide high-resolution, contrast-rich images. It is particularly effective in detecting hemorrhages, microbleeds, vascular anomalies, and iron deposition, often missed on conventional sequences. Objectives: To evaluate the clinical applications, diagnostic yield, and comparative advantages of SWI over conventional MRI in hospital-based neurological practice. Methods: A prospective observational study was conducted in the Department of Radiology at Silchar Medical College & Hospital from November 2023 to October 2024. Fifty patients aged 1 day to 85 years with neurological symptoms underwent brain MRI, including both conventional sequences and SWI. Detection rates of lesions, additional pathological findings, and subgroup analyses were compared. Statistical tests included Chi-square, McNemar?s test, ROC analysis, and Bland-Altman agreement. Results: SWI detected abnormalities in 100% of cases, compared to 16% with conventional MRI. Common conditions identified were stroke (24%), tumors (18%), and microbleeds (16%). Additional findings included hypertension-related microbleeds, sinus thrombosis, diffuse axonal injury, and hemorrhagic tumor features. McNemar?s test showed significant superiority of SWI (p < 0.00001), while Bland-Altman analysis confirmed consistent added detection. Conclusion: SWI substantially enhances diagnostic accuracy in neurological imaging, outperforming conventional MRI in detecting subtle and complex abnormalities. Its routine integration into clinical protocols is strongly recommended for improved patient care.