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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 24:512-514, March 2003
© 2003 American Society of Neuroradiology

Case Report
BRAIN

Black Holes on MR Images of the Brain of Patients with Björk-Shiley Heart Valves: Additional Observation in Three Cases

Maarten J. van Gorp^a, Bas A.J.M. de Mol^c, Chris J.G. Bakker^b, Yolanda van der Graaf^a and Willem P.T.M. Mali^b

^a Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht
^b Department of Radiology, University Medical Center Utrecht, Utrecht
^c Department of Cardiothoracic Surgery, Academic Medical Center, University of Amsterdam and Section of Safety Science, Delft University of Technology, Delft, The Netherlands

Address reprint requests to Y. van der Graaf, MD, PhD, Julius Center for Health Sciences and Primary Care, P.O. Box 85 500, D 01.335, 3508 GA, Utrecht, The Netherlands

Summary: We report the cases of three patients with Björk-Shiley convexo-concave heart valves with unusual black holes shown on cerebral MR images. For two patients, these findings were associated with fracture of the Björk-Shiley convexo-concave heart valve, and for the third, with worn surfaces on the heart valve. Susceptibility changes shown by MR imaging suggest the possibility that these black holes may be associated with microscopic metallic particles, although, the exact cause of these black holes remains undetermined.