Magnetic resonance imaging findings of cerebral venous malformations

Our study aimed to evaluate the incidence and anatomical locations of cerebral venous malformations (CVMs), their alterations over time, and magnetic resonance imaging (MRI) findings of their relationships with each other in patients who underwent magnetic susceptibility-weighted imaging (SWI) and contrast-enhanced MRI.

The drainage pattern of developmental venous anomalies (DVAs), the number of collecting veins, DVA thrombosis, signal-intensity abnormalities, and hemosiderin deposits (nodular, diffuse, or both) related to the DVA, were examined. The alterations over time in cavernomas (type and size) were assessed.

The study evaluated 7,826 patients who had 8,957 magnetic SWI and contrast-enhanced brain MRIs. A total of 643 CVMs were detected in 520 patients. The frequencies of DVAs, cavernomas, and capillary telangiectasias were 5.26%, 1.28%, and 0.62%, respectively. Isolated DVAs were detected in 430 (71.5%), cavernomas in 77 (12.8%), and capillary telangiectasias in 52 (8.7%) cases of CVMs. The coexistence of DVA with cavernoma and DVA with capillary telangiectasia was found in 38 (6.3%) and 4 (0.7%) cases, respectively. DVA drainage was largely provided by a single collecting vein. Signal-intensity abnormalities associated with the DVA were observed in 7, and two patients had DVA thrombosis. Hemosiderin deposits were nodular in 14 cases, diffuse in three, and both nodular and diffuse in two. In a follow-up of 11 (7.8%) cavernomas, alterations in the type and size were detected.

It is not uncommon for cavernomas to become symptomatic owing to alterations in their nature, size, and type over time, while DVAs rarely become symptomatic. Capillary telangiectasias are vascular malformations that tend to remain stable in terms of clinical and imaging features, and those with supratentorial localization are detected more frequently in the frontal lobe. On magnetic susceptibility sequences, hemosiderin deposits can be seen in the GVA region, not rarely but more frequently in nodular form, as well as in diffuse or nodular or diffuse and nodular forms.