Dynamic contrast-enhanced MRI evaluation of cerebral cavernous malformations

Area of Science:

• Neuroradiology
• Medical Imaging
• Biophysics

Background:

• Central nervous system cavernous malformations (CCMs) are vascular malformations.
• Assessing CCM behavior requires advanced imaging techniques.
• Dynamic contrast-enhanced MRI (DCEMRI) shows promise for evaluating slow contrast transfer rates.

Purpose of the Study:

• To quantitatively evaluate the behavior of CNS cavernous malformations (CCMs).
• To utilize a DCEMRI technique sensitive to slow gadolinium transfer rates.
• To compare transfer rates in CCMs to normal white matter and control subjects.

Main Methods:

• Prospective study involving 14 familial CCM subjects and 17 controls.
• DCEMRI performed on six slices using T1 mapping with partial inversion recovery (TAPIR).
• Gadolinium DTPA administered; transfer rate (Ki) calculated using the Patlak model.

Main Results:

• Thirty-nine CCMs were analyzed.
• Ki was low/normal in 12 lesions and elevated (1.4-12x background) in 27 lesions.
• CCM patient white matter Ki was not statistically different from controls.

Conclusions:

• TAPIR-based DCEMRI enables quantifiable in vivo assessment of CCMs.
• This technique reveals differences not apparent with conventional MRI.
• Potential applications include correlating CCMs with biologic behavior and drug effects.