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The authors evaluated the diagnostic accuracy of differentiating cerebral microbleeds and calcifications from phase patterns in axial locations in 31 consecutive patients undergoing both CT and MR imaging for acute infarction and exhibiting dark spots in gradient-echo magnitude images. Six patients had additional quantitative susceptibility mapping images. To determine their susceptibility, 2 radiologists separately investigated the phase patterns in the border and central sections. Among 190 gradient-echo dark spots, 62 calcifications and 128 cerebral microbleeds were detected from CT. Interobserver reliability was higher for the border phase patterns than for the central phase patterns. The sensitivity and specificity of the border phase patterns in identifying calcifications were higher than those of the central phase patterns, particularly for lesions >2.5 mm in diameter and quantitative susceptibility mapping of dark spots. They conclude that the border phase patterns were more accurate than the central phase patterns in differentiating calcifications and cerebral microbleeds and were as accurate as quantitative susceptibility mapping.