Reliability of Functional and Diffusion MR Imaging Near Cerebral Cavernous Malformations

Area of Science:

• Neurosurgery
• Neuroradiology
• Medical Imaging

Background:

• Cerebral cavernous malformations (CCMs) near eloquent brain regions necessitate precise surgical planning.
• Functional MRI (fMRI) and Diffusion Tensor Imaging (DTI) are crucial for preserving neurological function during CCM resection.

Purpose of the Study:

• To evaluate the reliability of fMRI and DTI in the surgical planning for CCMs.
• To compare the accuracy and precision of fMRI and DTI metrics near CCMs.

Main Methods:

• Fifty-four patients with CCMs underwent presurgical fMRI and DTI.
• Fractional anisotropy (FA) from DTI and regional homogeneity (ReHo) from fMRI were measured in regions of interest (ROIs) and compared to contralateral controls.
• Reliability, accuracy, and precision of FA and ReHo were assessed.

Main Results:

• Fractional anisotropy (FA) demonstrated higher reliability and precision than regional homogeneity (ReHo) near CCMs.
• ReHo measurements were significantly affected by proximity to CCMs and showed signal depression, unlike FA.
• FA was not significantly biased, whereas ReHo was biased toward lower signals.

Conclusions:

• Hemosiderin in CCMs can cause artifacts, leading to signal depression in fMRI, necessitating cautious interpretation.
• DTI remains a reliable imaging technique for surgical planning near CCMs, relatively unaffected by CCM-related artifacts.
• fMRI interpretation near CCMs requires careful consideration due to potential signal artifacts.