title: Magnetic resonance imaging evaluation of cerebral cavernous malformations with susceptibility-weighted imaging.
abstract: BACKGROUND
  Cerebral cavernous malformations (CCMs) can be sporadic or inherited, the latter characterized by multiple lesions. Novel imaging sequences have increased the sensitivity of detecting multiple CCMs.
  
  
  OBJECTIVE
  To compare T2-weighted gradient echo (T2*GRE) and susceptibility-weighted imaging (SWI) sequences in familial and sporadic CCM to assess their respective sensitivity.
  
  
  METHODS
  This prospective study included 23 consecutive cases grouped as multifocal/familial CCMs (n=14), solitary/clustered sporadic CCMs with developmental venous anomaly (n=8), and postirradiation CCMs (n=1). Brain magnetic resonance imaging included T2*GRE and SWI sequences. Two radiologists independently counted the number of lesions on each sequence. The difference in the number of lesions on both sequences was compared, and interobserver agreement was evaluated.
  
  
  RESULTS
  In multifocal/familial cases, a mean of 34.7 lesions were detected on T2*GRE and 66.9 on SWI (P=.001). The difference of lesion prevalence with the 2 techniques was significant (P=.006), with strong interobserver correlation for the T2*GRE sequence (P<.001) and SWI sequence (P<.001). Patients with solitary/clustered sporadic CCMs, including those associated with venous anomaly, had no difference in lesion prevalence in the 2 sequences.
  
  
  CONCLUSIONS
  SWI is more sensitive than T2*GRE in detecting CCM in multifocal/familial CCMs. Among cases classified as solitary/clustered with conventional imaging, including those associated with venous anomaly, the SWI did not impart additional sensitivity or reveal occult lesions not evident on T2*GRE sequence. No case was changed from the solitary/clustered to the multifocal clinical category because of SWI.
authors.affiliation: Department of Neuroradiology, CHU de Montpellier, Montpellier, France.
authors.forename: Nicolas Menjot
authors.initials: NM
authors.lastname: de Champfleur
authors.forename: Christophe
authors.initials: C
authors.lastname: Langlois
authors.forename: William J
authors.initials: WJ
authors.lastname: Ankenbrandt
authors.forename: Emmanuelle
authors.initials: E
authors.lastname: Le Bars
authors.forename: Marie Anne
authors.initials: MA
authors.lastname: Leroy
authors.forename: Hugues
authors.initials: H
authors.lastname: Duffau
authors.forename: Alain
authors.initials: A
authors.lastname: Bonafé
authors.forename: Jennifer
authors.initials: J
authors.lastname: Jaffe
authors.forename: Issam A
authors.initials: IA
authors.lastname: Awad
authors.forename: Pierre
authors.initials: P
authors.lastname: Labauge
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000175:diagnosis*; D005260:Female; D005602:France; D020786:Hemangioma, Cavernous, Central Nervous System / Q000175:diagnosis*; D006801:Humans; D007087:Illinois; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult