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Visualization of Amyloid β Deposits in the Human Brain with Matrix-assisted Laser Desorption/Ionization Imaging Mass Spectrometry
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Visualization of Amyloid β Deposits in the Human Brain with Matrix-assisted Laser Desorption/Ionization Imaging Mass Spectrometry

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Tumefactive cerebral amyloid angiopathy mimicking CNS neoplasm

Amy L Kotsenas1, Jonathan M Morris, John T Wald

  • 1Department of Radiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA. kotsenas.amy@mayo.edu

AJR. American Journal of Roentgenology
|December 21, 2012
PubMed
Abstract

Insights

Tumefactive cerebral amyloid angiopathy (CAA) is rare. Susceptibility MRI sequences can help diagnose this condition in elderly patients by identifying microhemorrhages, guiding biopsy and pathology.

Area of Science:

  • Neurology
  • Radiology
  • Pathology

Background:

  • Cerebral amyloid angiopathy (CAA) is a common cause of intracerebral hemorrhage in the elderly.
  • The tumefactive variant of CAA is a rare presentation that can mimic other brain lesions.
  • Accurate diagnosis is crucial for appropriate management.

Purpose of the Study:

  • To describe the imaging findings of tumefactive CAA.
  • To evaluate the utility of susceptibility-weighted MRI sequences in diagnosing tumefactive CAA.
  • To determine if imaging findings can guide further diagnostic workup.

Main Methods:

  • Retrospective review of imaging findings in patients with tumefactive lesions.
  • Focus on susceptibility-weighted MRI sequences (e.g., SWI, GRE).
  • Correlation of imaging findings with histopathological results.

Main Results:

  • Tumefactive CAA lesions exhibit characteristic imaging features on susceptibility sequences.
  • Diffuse microhemorrhages are a key finding associated with tumefactive CAA.
  • Susceptibility sequences aid in differentiating tumefactive CAA from other pathologies.

Conclusions:

  • Susceptibility MRI sequences are valuable in the prebiopsy evaluation of tumefactive brain lesions in the elderly.
  • Identifying diffuse microhemorrhages on susceptibility imaging should prompt consideration of CAA.
  • Targeted biopsy and specific pathologic staining are recommended for definitive diagnosis of CAA.

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