The Value of Susceptibility Weighted Magnetic Resonance Imaging in Evaluation of Patients With Familial Cerebral Cavernous Angioma

Int J Clin Exp Med. 2014 Dec 15;7(12):5296-302. eCollection 2014.

Abstract

Objectives: We investigated the imaging features of Cavernous angioma (CA) lesions and the value of Susceptibility-weighted imaging (SWI) by comparing with T2*-weighted gradient echo (GRE) sequences in patients with familial CA disease.

Material and methods: We retrospectively evaluated 19 familial CA patients (8 men, 11 women; mean age, 36 years). T1-weighted, T2-weighted, T2*-weighted GRE, and SWI sequences were performed to all patients. The numbers of CA lesions seen on T2*-weighted GRE and SWI sequences were analyzed. The correlations between the numbers of lesions on both sequences with age were evaluated. CA lesions were classified according to the classification of Zabramski et al.

Results: The number of CA lesions was higher on SWI than T2*-weighted GRE significantly (P<.001). There was a significant strong correlation between the age of the patients and number of lesions in the cohort on T2*-weighted GRE (r = 0.81, P<0.001) and SWI (r = 0.85, P<0.001) sequences. Approximately 44% of the CA lesions which were detected only by SWI could not be categorized according to the classification of Zabramski et al.

Conclusion: SWI can provide helpful additional information by determining the CA lesions more accurately than T2*-weighted GRE. Thus, routine clinical neuroimaging protocols should contain SWI to assess the true prevalence of lesions for optimal diagnosis and treatment. Moreover, this study show that the Zabramski classification is insufficient to identify all CA lesions, and a new type (type V) should be added to represent lesions that are seen on SWI but not on T2*-weighted GRE.

Keywords: Cavernous angioma; T2*-weighted gradient echo; cavernoma; cavernous malformation; susceptibility-weighted imaging.