Susceptibility-weighted imaging at 7T: Improved diagnosis of cerebral cavernous malformations and associated developmental venous anomalies

Abstract

Background and aimIn the diagnosis of cerebral cavernous malformations (CCMs) magnetic resonance imaging is established as the gold standard. Conventional MRI techniques have their drawbacks in the diagnosis of CCMs and associated venous malformations (DVAs). The aim of our study was to evaluate susceptibility weighted imaging SWI for the detection of CCM and associated DVAs at 7 T in comparison with 3 T.Patients and methods24 patients (14 female, 10 male; median age: 38.3 y (21.1 y–69.1 y) were included in the study. Patients enrolled in the study received a 3 T and a 7 T MRI on the same day. The following sequences were applied on both field strengths: a T1 weighted 3D GRE sequence (MP-RAGE) and a SWI sequence. After obtaining the study MRIs, eleven patients underwent surgery and 13 patients were followed conservatively or were treated radio-surgically.ResultsPatients initially presented with haemorrhage (n = 4, 16.7%), seizures (n = 2, 8.3%) or other neurology (n = 18, 75.0%). For surgical resected lesions histopathological findings verified the diagnosis of CCMs. A significantly higher number of CCMs was diagnosed at 7 T SWI sequences compared with 3 T SWI (p < 0.05). Additionally diagnosed lesions on 7 T MRI were significantly smaller compared to the initial lesions on 3 T MRIs (p < 0.001). Further, more associated DVAs were diagnosed at 7 T MRI compared to 3 T MRI.ConclusionSWI sequences at ultra-high-field MRI improve the diagnosis of CCMs and associated DVAs and therefore add important pre-operative information.

SPARKLING: variable‐density k‐space filling curves for accelerated T2*‐weighted MRI

“…Our findings may be of value in numerous MRI applications including , 70,71 proton‐density, 72 susceptibility‐weighted imaging (SWI) 73 and quantitative susceptibility mapping, 74 as our method paves the way to increases in spatial and temporal resolution under conditions compatible with clinical time constraints. Although our application focuses on imaging, the SPARKLING trajectories may be used for other contrast such as or or for dynamic imaging, by adapting the acquisition parameters.…”

The Many Faces of Cerebral Developmental Venous Anomaly and Its Mimicks: Spectrum of Imaging Findings

“…SWI shows a high sensitivity for pathologies that cause magnetic field inhomogeneity such as deoxygenated blood, hemosiderin, ferritin, and calcium . SWI is useful for the detection of both cavernous malformations and DVAs; the sensitivity increases with increased magnetic field strength (ie, 3 T vs. 1.5 T) …”

Magnetic resonance susceptibility weighted imaging in neurosurgery: current applications and future perspectives

“…9), 53 and low-flow VMs, including CCM, 20,23,88 brain capillary telangiectasia, 28 or Sturge-Weber syndrome. 48,110 Most importantly, the findings from SWI, especially at ultrahigh fields (that is, 7 T), 29 are shown to correlate with histopathological studies. 88 SWI is a promising technique since its findings correlate well with "gold-standard" techniques for detecting VMs, including digital subtraction angiography and time-of-flight MRA.…”

“…Various studies have demonstrated the effectiveness of SWI in outcome prediction using SWI for hemorrhage grading, 51 the dichotomization of patients with and those without CMBs, 29,33 or the detection of a greater number and volume of lesions. 5,9,94,95,99 Despite having various SWI methods for outcome prediction, the current state of research has yet to reveal which method would exhibit the highest accuracy and specificity in predicting outcome and recovery.…”