Cavernous brain malformations and their relation to black blood MRI in respect to vessel wall contrast enhancement
Athanasios K Petridis1, Marian P Suresh1, Jan F Cornelius1
1Department of Neurosurgery, Heinrich Heine University Düsseldorf, Moorenstr 5, 40225 Düsseldorf, Germany.
Background:
Inflammatory responses are implicated as crucial patho-mechanisms of vascular brain malformations. Inflammation is suggested to be a key contributor to aneurysm rupture; however it is unclear whether inflammation contributes similarly to bleeding of cerebral cavernous malformations (CCMs). Black blood MRI is a sequence which identifies inflammation in blood vessel walls and in the present study is used to detect inflammatory response in CCMs.
Methods:
Fifteen patients with 17 CCMs treated in our department in 2017 were retrospectively analysed. All patients received black blood MRIs and the results were analysed in correlation with, size and bleeding of CCMs.
Results:
Size and bleeding status of CCMs did not correlate with contrast enhancement in the CCM wall. One of 3 patients with bleeding displayed contrast enhancement in black blood MRI, whereas the others had non enhancing lesions. Because of the small number of cases a statistical analysis was not performed.
Conclusion:
In this limited cohort, inflammatory reactions in CCMs could not be detected by black blood MRI suggesting that the level of inflammation is minimal in these lesions and those different patho-mechanisms play a more important role in the rupture of CCMs.
Insights
Black blood MRI did not detect inflammation in cerebral cavernous malformations (CCMs), suggesting minimal inflammation and other mechanisms in CCM bleeding.
Area of Science:
- Neurology
- Vascular Malformations
- Medical Imaging
Background:
- Inflammatory responses are key in vascular brain malformations.
- Inflammation is linked to aneurysm rupture, but its role in cerebral cavernous malformations (CCMs) bleeding is unclear.
- Black blood MRI detects inflammation in blood vessel walls.
Purpose of the Study:
- To investigate inflammatory responses in CCMs using black blood MRI.
- To determine if inflammation correlates with CCM size and bleeding.
Main Methods:
- Retrospective analysis of 15 patients with 17 CCMs.
- All patients underwent black blood MRI.
- MRI results were correlated with CCM size and bleeding status.
Main Results:
- CCM size and bleeding status did not correlate with contrast enhancement in the CCM wall.
- Only one of three bleeding CCMs showed contrast enhancement on black blood MRI.
- Statistical analysis was not performed due to the small sample size.
Conclusions:
- Black blood MRI could not detect significant inflammatory reactions in this limited CCM cohort.
- The level of inflammation in CCMs appears minimal.
- Different pathophysiological mechanisms likely drive CCM rupture.
