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Susceptibility-weighted MR imaging: a better technique in the detection of capillary telangiectasia compared with T2*
U S Chaudhry1, D E De Bruin2, B A Policeni3
1From the Department of Radiology (U.S.C., D.E.D., B.A.P.).
Background And Purpose:
Enhancing lesions on brain MR imaging can present a diagnostic quandary as both benign lesions such as brain capillary telangiectasia and pathologic lesions such as demyelination may appear similar. Stagnation of blood in low-flow venous channels of brain capillary telangiectasias results in susceptibility effect secondary to the increased local deoxyhemoglobin. Both T2* gradient-echo imaging and SWI were demonstrated as valuable in the diagnosis of brain capillary telangiectasia. Because SWI is more sensitive to susceptibility changes than gradient-echo, we aim to demonstrate increased diagnostic value of SWI compared with gradient-echo in making the diagnosis of brain capillary telangiectasia.
Materials And Methods:
We retrospectively reviewed the MR images of 17 patients with a presumed diagnosis of brain capillary telangiectasia and who were examined from June 2010 to September 2012. All patients underwent MR imaging at 1.5T with T1, T2, FLAIR, gradient-echo, SWI, and gadolinium-enhanced T1 sequences. Lesions were evaluated for the presence or absence of signal abnormality on each particular sequence.
Results:
All 17 brain capillary telangiectasias demonstrated distinct signal-intensity loss on SWI compared with 7 of 17 (41%) who showed signal-intensity loss on gradient-echo. The increased frequency of detection using SWI versus gradient-echo is statistically significant (z = 2.85, P < .01; χ(2) = 8.10, P < .01). Six of the lesions showed signal-intensity changes on T1 and/or T2 whereas the remaining lesions were isointense to normal brain.
Conclusions:
Brain capillary telangiectasias are more conspicuous on SWI than gradient-echo imaging and other precontrast MR imaging. SWI is a valuable tool in diagnosing these benign lesions and should serve to increase diagnostic confidence.
Insights
Susceptibility Weighted Imaging (SWI) is more effective than gradient-echo for diagnosing brain capillary telangiectasia. SWI enhances lesion visibility, improving diagnostic confidence for this benign condition.
Area of Science:
- Neuroradiology
- Neuroimaging
- Vascular Malformations
Background:
- Brain capillary telangiectasia (BCT) diagnosis is challenging due to overlapping imaging features with other lesions.
- Blood stagnation in BCT causes susceptibility effects from deoxyhemoglobin, detectable by MRI.
Purpose of the Study:
- To compare the diagnostic value of Susceptibility Weighted Imaging (SWI) against T2* gradient-echo (GRE) for BCT.
- To demonstrate SWI's increased sensitivity in detecting BCT lesions.
Main Methods:
- Retrospective review of 17 patients with presumed BCT.
- All patients underwent 1.5T MRI including T1, T2, FLAIR, GRE, SWI, and contrast-enhanced T1 sequences.
- Lesion signal abnormalities were evaluated across all sequences.
Main Results:
- All 17 BCTs showed signal loss on SWI.
- Only 7 of 17 (41%) BCTs showed signal loss on GRE (P < .01).
- SWI significantly increased lesion detection frequency compared to GRE.
Conclusions:
- Brain capillary telangiectasias are more conspicuous on SWI than GRE.
- SWI is a valuable tool for diagnosing BCT, enhancing diagnostic confidence.
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