Katja Pinker MD, Presenter: Research funded, Bracco Group

Ioannis Stavrou MD, Abstract Co-Author: Nothing to Disclose

Romana Hoeftberger MD, Abstract Co-Author: Nothing to Disclose

Michael Weber, Abstract Co-Author: Nothing to Disclose

Andreas Stadlbauer MS, Abstract Co-Author: Nothing to Disclose

Engelbert Knosp MD, Abstract Co-Author: Nothing to Disclose

Siegfried Trattnig MD, Abstract Co-Author: Support, Bracco Group

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To compare high-field, high-resolution, susceptibility-weighted magnetic resonance imaging (3T HR-SW-MRI) and standard (1.5T) MRI for the detection of cerebral cavernomas. To evaluate the ability of 3T HR-SW-MRI to visualize intralesional structures compared to standard (1.5T) MRI, in correlation with histopathological findings.

Seventeen patients with cerebral cavernomas underwent both standard (1.5T) MRI (T1-SE, T2-TSE, T2*-GRE) and 3T HR-SW-MRI (TR/TE 43.3/9.1ms; 512x384x48 matrix; FOV 250mm; SI 72mm) at our institution. All MR images were evaluated by three radiologists in consensus for detectability, size (1cm), and conspicuity (good, acceptable, poor) of the lesions at both field strengths, and for the presence of hypointense intralesional tubular structures. In seven patients, MR findings were correlated with histopathological findings.

Both 3T HR-SW-MRI and standard (1.5T) MRI detected twenty-two lesions in seventeen patients; 3T HR-SW-MRI detected an additional seven lesions in six patients. On average, 3T HR-SW-MRI detected 1.706 ± 0.92 (median=1) lesions per patient, whereas standard (1.5T) MRI detected 1.235 ± 0.664 lesions per patient (p=0.016). Lesion conspicuity was good in all 3T HR-SW-MR images, and good in 68.2% and acceptable in 31.8% of standard (1.5T) MR images (p=0.016). In 22 lesions detected at both field strengths, 3T HR-SW-MRI demonstrated intralesional tubular structures in 72.7% and standard (1.5T) MRI demonstrated these structures in 31.8% (p=0.001). Intralesional tubular structure correlated to conglomerates of cavernous vessel, as verified by histopathology.

Compared to standard (1.5T) MRI, 3T HR-SW-MRI allows superior detection and characterization of cerebral cavernomas. Despite increased susceptibility effects, i.e., signal loss at higher magnetic field strengths, the visualization of intralesional tubular structures, respectively conglomerates of cavernous vessels, is feasible.

3T HR-SW-MRI allows improved diagnosis of cerebral cavernomas and thus can optimize the presurgical planning and the non-invasive follow-up after gamma-knife radio surgery.

Pinker, K, Stavrou, I, Hoeftberger, R, Weber, M, Stadlbauer, A, Knosp, E, Trattnig, S, et al, , et al, , Improved preoperative evaluation of cerebral cavernomas by high-field, high-resolution susceptibility-weighted magnetic resonance imaging (HR-SW-MRI) at 3 Tesla – Comparison with standard (1.5T) MRI and correlation with histopathological findings.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5001760.html