Teaching NeuroImages: Diffuse cerebrovascular susceptibility artifact following ferumoxytol infusion

A 79-year-old woman presented with dysarthria, aphasia, and right hemiparesis. MRI of the brain demonstrated a small acute infarct in the left temporoparietal convexity (figure 1) and a marked decrease in susceptibility signal of the cerebral vasculature (figure 2). Due to her religious beliefs (Jehovah's Witness), the patient’s anemia is treated with ferumoxytol infusions rather than red blood cell transfusion. She received an infusion 1 day prior to her scan. Susceptibility artifact of cerebral vasculature following IV iron therapy has been described.1 Ferumoxytol has gained interest as an MRI contrast agent in patients with decreased renal function.2