The MRI Imaging of Cerebral Cavernous Malformation With Practical Use of Diffusion Weighted Image

Abstract

Aim: To evaluate the significance of diffusion weighted image(DWI) of the cerebral cavernous malformation in clinical practice. Materials and Methods: Thirty patients with 66 lesions (multiple 5 cases) were included in this study. The signal, configuration, anatomical location, size, and the number on each T1WI, T2WI, FLAIR, T2WI*, DWI, Gd (gadolinium)-T1WI,and the sequential signal change of DWI(central and peripheral area in cavernoma)were recorded. Results: The cerebral cavernous malformation (CCM) shows the signal of various phase of hematoma (hemorrhage)on both T1WI and T2WI MRI. On the diffusion weighted imaging (DWI), they showed the marked low (43.3%)and mixed high and low signal intensity (33.3%)even if they were very small appearing as areas of decreased signal (black dots) on T2WI.The low intense signal area on DWI assumed to reflect the hemosiderin or susceptibility effect and blood oxygen level dependent (BOLD)effect by the deoxyhemoglobin and T2 black out effect. The transient high signal foci on DWI were observed in 2(6.7%) cases in whom the intratumoral (re)hemorrhage were suspected. Conclusions: The CCM tends to exhibit almost low signal intensity on DWI.DWI is a useful method like T2*WI and SWI for the detection of the tiny CCM.