Susceptibility-Weighted Imaging for the Evaluation of Patients with Familial Cerebral Cavernous Malformations: A Comparison with T2-Weighted Fast Spin-Echo and Gradient-Echo Sequences

Souza, Jorge Marcondes de; Domingues, R. C.; Cruz, Luiz Celso Hygino da; Domingues, Flavio S.; Iasbeck, T.; Gasparetto, Emerson L.

doi:10.3174/ajnr.a0748

Cited by 150 publications

(90 citation statements)

References 11 publications

(29 reference statements)

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“…3 In a previous study of pediatric patients with cortical laminar necrosis evaluated with SWI, only 20% of the patients had signals of laminar or dotted hemorrhage. 4 In conclusion, MR imaging follow-up is essential for monitoring patients with WE with cortical abnormalities due to the risk of irreversibility of lesions, which may progress to cortical laminar necrosis and hemorrhage.…”

Section: 2mentioning

confidence: 99%

Nonalcoholic Wernicke Encephalopathy with Extensive Cortical Involvement: Cortical Laminar Necrosis and Hemorrhage Demonstrated with Susceptibility-Weighted MR Phase Images: Fig 1.

Pereira¹,

Pereira²,

Gasparetto³

2011

AJNR Am J Neuroradiol

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Wernicke encephalopathy (WE) is an acute neuropsychiatric condition due to an initially reversible brain lesion caused by depleted intracellular thiamine levels in neurons.1 Most of the affected patients are malnourished alcoholics; however, WE has also been associated with other conditions. The typical MR imaging features are symmetric hyperintensity on T2-weighted images in the medial thalami, mamillary bodies, tectal plate, periaqueductal area, and floor of the fourth ventricle. 1 Atypical MR imaging findings, such as signal-intensity abnormalities in cranial nerve nuclei, cerebellum dentate nuclei, vermis, putamina, red nuclei, caudate nuclei, splenium, and cerebral cortex, have been more frequently described in nonalcoholic WE.

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Section: 2mentioning

confidence: 99%

Nonalcoholic Wernicke Encephalopathy with Extensive Cortical Involvement: Cortical Laminar Necrosis and Hemorrhage Demonstrated with Susceptibility-Weighted MR Phase Images: Fig 1.

Pereira¹,

Pereira²,

Gasparetto³

2011

AJNR Am J Neuroradiol

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“…As per currently accepted disease categorization [2,18,19], cases were classified as sporadic if they harbored a solitary lesion on the most sensitive susceptibilityweighted imaging (SWI) MRI sequences, or a cluster of lesions associated with a developmental venous anomaly. They were classified as familial if they harbored multifocal CCM lesions, a family history of CCM in a first degree blood relative, or a mutation genotyped at a CCM gene locus.…”

Section: Patient Recruitment and Categorization Of Diseasementioning

confidence: 99%

“…Predictive thresholds & combination of two biomarkers as a predictor for cerebral cavernous malformation disease aggressiveness ROC curves [18,19] were generated and the area under the curve (AUC) was calculated to evaluate each individual biomarker and their combination's ability to predict CCM chronic disease aggressiveness. The linear combination of 25-(OH) vitamin D and non-HDL cholesterol was generated using the canonical linear discriminant analysis [22,23], with the equation shown here:…”

Section: -(Oh) Vitamin D and Non-high-density Lipoprotein Cholesterolmentioning

confidence: 99%

Peripheral Plasma Vitamin D and Non-HDL Cholesterol Reflect the Severity of Cerebral Cavernous Malformation Disease

et al. 2016

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Aim: To correlate cerebral cavernous malformations (CCMs) disease aggressiveness with peripheral blood biomarkers hypothesized mechanistically. Patients & methods: A prospective case–control study enrolled 43 CCM patients, where 25-(OH) vitamin D, HDL and non-HDL cholesterol, CRP plasma levels and leukocyte ROCK activity were correlated with parameters of disease aggressiveness reflecting chronic and acute domains. Results: Patients with one or more features of chronically aggressive disease (early age at symptom onset, two or more symptomatic bleeds, high lesion burden) had significantly lower 25-(OH) vitamin D and non-HDL cholesterol levels in comparison to patients without these features. Conclusion: Validation of these biomarkers and their potential treatment modulation may influence the clinical care of patients with CCM disease.

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“…1,3 SWI may prove to be outstandingly useful in identifying the true extent of cavernous malformations or in confirming the presence of suspected small CCMs.…”

mentioning

confidence: 99%

Pneumocephalus Mimicking Cerebral Cavernous Malformations in MR Susceptibility-Weighted Imaging: Fig 1.

Palma¹,

Zubieta²,

Domínguez³

et al. 2009

AJNR Am J Neuroradiol

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We read with interest the article by de Souza et al 1 about the use of susceptibility-weighted imaging (SWI) for the evaluation of patients with cerebral cavernous malformations (CCMs). In this regard, we would like to report the following case: In November 2008, a 38-yearold woman presented with a history of left tinnitus and hypoacusis. The usual MR imaging sequences showed a left acoustic neurinoma; she also was found to have a single CCM in the left frontal region as an incidental finding. She underwent surgery, and a small CSF fistula presented through the surgical wound as complication. A new MR imaging was performed, adding SWI, showing several lesions that suggested the presence of multiple CCMs (in addition to the frontal cavernous malformation previously diagnosed) that were not seen on the usual sequences (Fig 1). The clinical correlation with the patient's medical history and a thorough analysis of the images led to the suspicion that the lesions seen on SWI corresponded to extra-axial air collections. A second intervention to close the CSF fistula and remove the frontal cavernous malformation was performed without complications, and the patient was discharged shortly after.SWI is a relatively new MR imaging technique suitable for detection of magnetic susceptibility effects.2 SWI is more sensitive than T2*-weighted gradient-refocused images in CCMs. 1,3 SWI may prove to be outstandingly useful in identifying the true extent of cavernous malformations or in confirming the presence of suspected small CCMs.However, as stated by Tong et al, 4 the loss of signal intensity created by a disturbance of a homogeneous magnetic field seen on SWI can be caused by various paramagnetic, ferromagnetic, or diamagnetic substances such as iron, some forms of calcification, or even air. Additionally, this fact may suggest that SWI could be a suitable sequence for monitoring the progress of recovery from pneumocephalus in neurosurgical patients. References

show abstract

Susceptibility-Weighted Imaging for the Evaluation of Patients with Familial Cerebral Cavernous Malformations: A Comparison with T2-Weighted Fast Spin-Echo and Gradient-Echo Sequences

Cited by 150 publications

References 11 publications

Nonalcoholic Wernicke Encephalopathy with Extensive Cortical Involvement: Cortical Laminar Necrosis and Hemorrhage Demonstrated with Susceptibility-Weighted MR Phase Images: Fig 1.

Nonalcoholic Wernicke Encephalopathy with Extensive Cortical Involvement: Cortical Laminar Necrosis and Hemorrhage Demonstrated with Susceptibility-Weighted MR Phase Images: Fig 1.

Peripheral Plasma Vitamin D and Non-HDL Cholesterol Reflect the Severity of Cerebral Cavernous Malformation Disease

Pneumocephalus Mimicking Cerebral Cavernous Malformations in MR Susceptibility-Weighted Imaging: Fig 1.

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