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Imaging Cavernous Malformations

F. Allan Midyett¹, Laurie Fisher², Suresh Mukherji³

¹UA North Texas Healthcare, Dallas, Texas
²Siemens Uptime Service Center, Cary, North Carolina
³University of Michigan, Ann Arbor, Michigan

Publication Name:

Current Protocols in Magnetic Resonance Imaging

Unit Number:

Unit A2.2

DOI:

10.1002/0471142719.mia0202s05

Online Posting Date:

August, 2002

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Abstract

This unit describes a Basic Protocol for evaluating cavernous malformations (CMs). CMs represent ~10% to 15% of vascular malformations. They consist of enlarged sinusoidal vascular spaces that have thin walls devoid of smooth muscle and normal endothelium. These form compact masses within central nervous system (CNS) parenchyma or associated structures without normal interspersed tissue. The thin walls lack normal endothelium and are prone to leakage of blood elements.

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Unit Introduction
Basic Protocol: Cavernous Malformation
Commentary
Bibliography
Figures
Tables

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Materials

Basic Protocol: Cavernous Malformation

Materials

Normal saline (0.9% NaCl)
Sterile extravascular contrast agent (e.g., Magnevist, Omniscan, Prohance)

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Figures

Figure A2.2.1

Coronal T₂-weighted image.

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Figure A2.2.2

Transverse T₁-weighted spin echo image. The classic appearance of a cavernoma in an unusual intraventricular location.

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Figure A2.2.3

T₂-weighted transverse image.

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Figure A2.2.4

T₁-weighted sagittal image without gadolinium.

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Figure A2.2.5

Noncontrast coronal multiecho T₂-weighted image.

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Figure A2.2.6

T₂-weighted sagittal image.

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Figure A2.2.7

T₂-weighted transverse image.

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Figure A2.2.8

T₁-weighted transverse image without gadolinium.

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Figure A2.2.9

T₁-weighted transverse image with gadolinium.

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Figure A2.2.10

T₁-weighted sagittal image without gadolinium.

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Figure A2.2.11

T₂-weighted transverse image.

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Literature Cited

Literature Cited
	Fischbein, N.J, Dillon, W.P., Barkovich, A.J (eds.) 2000. Teaching Atlas of Brain Imaging, pp. 272-275. Thieme, New York.
	Glendhill, K., Moore, K.R., Jacobs, M, and Orrison, W.W., Jr., (eds.) 2000. Chapter 21. In Neuroimaging, pp. 252-755. W.B. Saunders, Philadelphia.
	Mason, I., Aase, J.M., Orrison, W.W., Wicks, J.D., Seigel, R.S., and Bicknell, J.M. 1988. Familial cavernous Angiomas of the brain in an Hispanic family. Neurology 38:324-326.
	Mitchell, D.G. 1999. MRI Principles, pp. 266-267. W.B. Saunders, Philadelphia.
	Rigamonti, D., Drayer, B.P., Johnson, P.C., Hadley, M.N., Zabramski, J., and Spetzler, R.F. 1987. The MRI appearance of cavernous malformations (Angiomas). J. Neurosurgery 67:518-524.
	Robinson, J.R., Awad, I.A., Little, J.R. 1991 Natural history of the cavernous angioma. J. Neurosurgery 75:709-714.
	Shellock, F.G. 1996. Pocket Guide to MR Procedures and Metallic Objects. Lippincott-Raven, Philadelphia.
	Tomlinson, F.H., Houser, O.W., Scheithauer, B.W., Sundt, T.M., Jr., Okozaki, H., and Parisa, J.E. 1994. Angiographically occult vascular malformations: A correlative study of features on magnetic resonance imaging and histological examination. Neurosurgery 34:792-800.
	Wilson, C.B. 1992. Cryptic vascular malformations. Clinics Neurosurg. 38:49-84.
Key References
	Fischbein, 2000. See above.
These authors afford a current concise look at intracranial vascular malformations. In addition to imaging findings, they discuss etiology, clinical findings, treatment, complications, pearls and pitfalls.
	Shellock, 1996. See above.
Covers a number of important patient management issues related to MR imaging, including recommended safety procedures, a list of metallic implants that have been tested for MR compatibility, and a list of other sources on MR safety.