title: Susceptibility-weighted imaging at 7 T: Improved diagnosis of cerebral cavernous malformations and associated developmental venous anomalies.
abstract: OBJECTIVE
  In the diagnosis of cerebral cavernous malformations (CCMs) magnetic resonance imaging is established as the gold standard. Conventional MRI techniques have their drawbacks in the diagnosis of CCMs and associated venous malformations (DVAs). The aim of our study was to evaluate susceptibility weighted imaging SWI for the detection of CCM and associated DVAs at 7 T in comparison with 3 T.
  
  
  METHODS
  24 patients (14 female, 10 male; median age: 38.3 y (21.1 y-69.1 y) were included in the study. Patients enrolled in the study received a 3 T and a 7 T MRI on the same day. The following sequences were applied on both field strengths: a T1 weighted 3D GRE sequence (MP-RAGE) and a SWI sequence. After obtaining the study MRIs, eleven patients underwent surgery and 13 patients were followed conservatively or were treated radio-surgically.
  
  
  RESULTS
  Patients initially presented with haemorrhage (n = 4, 16.7%), seizures (n = 2, 8.3%) or other neurology (n = 18, 75.0%). For surgical resected lesions histopathological findings verified the diagnosis of CCMs. A significantly higher number of CCMs was diagnosed at 7 T SWI sequences compared with 3 T SWI (p < 0.05). Additionally diagnosed lesions on 7 T MRI were significantly smaller compared to the initial lesions on 3 T MRIs (p < 0.001). Further, more associated DVAs were diagnosed at 7 T MRI compared to 3 T MRI.
  
  
  CONCLUSIONS
  SWI sequences at ultra-high-field MRI improve the diagnosis of CCMs and associated DVAs and therefore add important pre-operative information.
authors.affiliation: Medical University Vienna, Department of Neurosurgery, Vienna, Austria.
authors.forename: Josa M
authors.initials: JM
authors.lastname: Frischer
authors.forename: Sabine
authors.initials: S
authors.lastname: Göd
authors.forename: Andreas
authors.initials: A
authors.lastname: Gruber
authors.forename: Walter
authors.initials: W
authors.lastname: Saringer
authors.forename: Günther
authors.initials: G
authors.lastname: Grabner
authors.forename: Brigitte
authors.initials: B
authors.lastname: Gatterbauer
authors.forename: Klaus
authors.initials: K
authors.lastname: Kitz
authors.forename: Sabrina
authors.initials: S
authors.lastname: Holzer
authors.forename: Claudia
authors.initials: C
authors.lastname: Kronnerwetter
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Hainfellner
authors.forename: Engelbert
authors.initials: E
authors.lastname: Knosp
authors.forename: Siegfried
authors.initials: S
authors.lastname: Trattnig
keywords: CCMs, cerebral cavernous malformations; Cerebral cavernous malformations; DVA, developmental venous malformation; High field MRI; SWI, susceptibility weighted imaging; Susceptibility weighted imaging