Susceptibility-Weighted MR Imaging for Diagnosis of Capillary Telangiectasia of the Brain

El-Koussy, Marwan; Schroth, Gerhard; Gralla, Jan; Brekenfeld, Caspar; Andres, Robert H.; Jung, So Lyung; Shahin, M.; Lövblad, Karl‐Olof; Kiefer, Claus; Kottke, Raimund

doi:10.3174/ajnr.a2893

Cited by 43 publications

(20 citation statements)

References 23 publications

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“…10,27 For small BCTs, T1-and T2-weighted images alone are oftentimes insufficient to establish a diagnosis, so that susceptibility-weighted images and diffusion-weighted images are often required. 5,7,9,10 In contrast, large BCTs can be visualized on T1-and T2-weighted images as the vessel abnormalities are quite prominent. 9 After contrast administration, larger BCTs often demonstrate weblike linear enhancement with heterogeneously intense nodules.…”

Section: Diagnosis Of Bctsmentioning

confidence: 99%

“…5,7,9,10 In contrast, large BCTs can be visualized on T1-and T2-weighted images as the vessel abnormalities are quite prominent. 9 After contrast administration, larger BCTs often demonstrate weblike linear enhancement with heterogeneously intense nodules. 9 In our series, the lesions were visible on T1-and T2-weighted images in Cases 1 and 2, presenting as prominent brushlike cone-shaped lesions with linear enhancement accompanied by interspersed hypo-and hyperintense nodules.…”

Section: Diagnosis Of Bctsmentioning

confidence: 99%

“…12 Ischemic accident has been reported in previous studies. 9,27,29 In addition, development of an aggressive form with increased risk of bleeding from giant or diffuse BCTs has also been reported. 24,29 In the existing reports of 10 cases of symptomatic large BCTs, 8 underwent resection.…”

Section: Treatment Of Large or Giant Bctsmentioning

confidence: 99%

“…9 After contrast administration, larger BCTs often demonstrate weblike linear enhancement with heterogeneously intense nodules. 9 In our series, the lesions were visible on T1-and T2-weighted images in Cases 1 and 2, presenting as prominent brushlike cone-shaped lesions with linear enhancement accompanied by interspersed hypo-and hyperintense nodules. On T2-weighted images, a hypointense margin around the proximal part of the lesions was observed in 3 cases, suggestive of old hemorrhage or a coexisting CM.…”

Section: Diagnosis Of Bctsmentioning

confidence: 99%

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Symptomatic large or giant capillary telangiectasias: management and outcome in 5 cases

Yu¹,

Sun²,

You

et al. 2016

JNS

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B rain capillary telangiectasia (BCT) is a rare vascular malformation with a prevalence of 0.4%-0.7% based on autopsy and MRI diagnosis. 12 Most BCTs are small in size and clinically silent with a predilection of pons and basal ganglia. Clinical data of large and symptomatic BCTs are rare. Only 10 symptomatic cases with 3 diffuse BCTs have been reported in the English-language literature of more than 200 BCTs. 12,20,24,27,29 Large BCTs have a much higher risk of causing uncontrolled bleeding and severe neurological deficits and even death if left untreated. 2,12,13,21,22 Therefore, large BCTs should be managed with special caution. Due to their rarity, the diagnosis of large BCTs has been difficult. 29,30 Large BCTs have different radiological characteristics, histopathological characteristics, and clinical courses from small BCTs. 8,12,25 Standard management is undefined for large or giant BCTs. 7,12,20,24,27,29 To our knowledge, the current study presents the largest case series of large BCTs ever reported. We analyzed the radiological findings, histopathological characteristics, clinical presentation, and management in 5 symptomatic, unusually large BCTs (mean diameter 5.06 cm, range 1.8-8 cm). Coexisting cavernous malformations (CMs) were confirmed in 3 cases. Resections were performed in all patients to control seizures and other recurrent neurological events.abbreviatioNs BCT = brain capillary telangiectasia; CM = cavernous malformation; DSA = digital subtraction angiography; ECoG = electrocorticography; EEG = electroencephalography. Brain capillary telangiectasias (BCTs) are usually small and benign with a predilection in the pons and basal ganglion. Reports of large and symptomatic BCTs are rare. Large BCTs have a much higher risk of causing uncontrolled bleeding and severe neurological defects, and they can be fatal if left untreated. Therefore, large BCTs should be managed with special caution. Because of the lack of reports, diagnosis of large BCTs has been difficult. Strategies of management are undefined for large or giant BCTs. The current study presents 5 cases of giant and large BCTs. To the authors' knowledge, this is the largest series of this disease ever reported. Radiological findings, histopathological characteristics, clinical presentations, and surgical management were analyzed in 5 symptomatic, unusually large BCTs (mean diameter 5.06 cm, range 1.8-8 cm). Four patients presented with focal or generalized seizures, and 1 patient presented with transient vision loss attributed to the lesions. Gross-total resection of the lesion was achieved in all patients. After surgery, the 4 patients with seizures were symptom free for follow-up periods varying from more than 1 to 5 years with no additional neurological deficits. The unique location, radiological characteristics, and clinical course suggest that giant BCTs could be a different entity from small BCTs. Surgery might be a good option for treatment of patients with intractable neurological symptoms, especially in those with surgically acce...

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Section: Diagnosis Of Bctsmentioning

confidence: 99%

Section: Diagnosis Of Bctsmentioning

confidence: 99%

Section: Treatment Of Large or Giant Bctsmentioning

confidence: 99%

Section: Diagnosis Of Bctsmentioning

confidence: 99%

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Symptomatic large or giant capillary telangiectasias: management and outcome in 5 cases

Yu¹,

Sun²,

You

et al. 2016

JNS

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“…It requires selected MRI sequences, contrast administration, and ideally, high magnet strengths for clear identification. 59 It is believed to pose no risk of hemorrhage and is not a common incidental finding in childhood. 60 AVMs vary greatly in size and complexity, but the defining feature is the direct connection between the arterial and venous systems without an intervening capillary bed.…”

Section: Incidental Vascular Lesionsmentioning

confidence: 99%

Incidental Findings on Brain and Spine Imaging in Children

Maher¹,

Piatt²,

Ragheb³

et al. 2015

Pediatrics

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In recent years, the utilization of diagnostic imaging of the brain and spine in children has increased dramatically, leading to a corresponding increase in the detection of incidental findings of the central nervous system. Patients with unexpected findings on imaging are often referred for subspecialty evaluation. Even with rational use of diagnostic imaging and subspecialty consultation, the diagnostic process will always generate unexpected findings that must be explained and managed. Familiarity with the most common findings that are discovered incidentally on diagnostic imaging of the brain and spine will assist the pediatrician in providing counseling to families and in making recommendations in conjunction with a neurosurgeon, when needed, regarding additional treatments and prognosis.

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Susceptibility-weighted imaging in pediatric neuroimaging

Bosemani

Poretti

Huisman

2013

J. Magn. Reson. Imaging

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Susceptibility-weighted imaging (SWI) has become a key MR sequence in pediatric neuroimaging. The usage of SWI has significantly expanded recently. The strength of SWI lies not just in its ability to identify hemorrhage, calcium or nonheme iron by virtue of its susceptibility artifact, but also more importantly, the blood oxygen level dependent venography principle whereby several diseases can be diagnosed earlier. We are continuing to harness the power of SWI in the field of pediatric neuroimaging. In this paper, we will make a comprehensive review and discuss the utility of SWI in pediatric neuroimaging in establishing the diagnosis, differential diagnosis, and also understanding the pathomechanism of various pediatric brain pathologies.

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Susceptibility-Weighted MR Imaging for Diagnosis of Capillary Telangiectasia of the Brain

Cited by 43 publications

References 23 publications

Symptomatic large or giant capillary telangiectasias: management and outcome in 5 cases

Symptomatic large or giant capillary telangiectasias: management and outcome in 5 cases

Incidental Findings on Brain and Spine Imaging in Children

Susceptibility-weighted imaging in pediatric neuroimaging

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