title: Susceptibility-weighted MR imaging: a better technique in the detection of capillary telangiectasia compared with T2* gradient-echo.
abstract: OBJECTIVE
  Enhancing lesions on brain MR imaging can present a diagnostic quandary as both benign lesions such as brain capillary telangiectasia and pathologic lesions such as demyelination may appear similar. Stagnation of blood in low-flow venous channels of brain capillary telangiectasias results in susceptibility effect secondary to the increased local deoxyhemoglobin. Both T2* gradient-echo imaging and SWI were demonstrated as valuable in the diagnosis of brain capillary telangiectasia. Because SWI is more sensitive to susceptibility changes than gradient-echo, we aim to demonstrate increased diagnostic value of SWI compared with gradient-echo in making the diagnosis of brain capillary telangiectasia.
  
  
  METHODS
  We retrospectively reviewed the MR images of 17 patients with a presumed diagnosis of brain capillary telangiectasia and who were examined from June 2010 to September 2012. All patients underwent MR imaging at 1.5T with T1, T2, FLAIR, gradient-echo, SWI, and gadolinium-enhanced T1 sequences. Lesions were evaluated for the presence or absence of signal abnormality on each particular sequence.
  
  
  RESULTS
  All 17 brain capillary telangiectasias demonstrated distinct signal-intensity loss on SWI compared with 7 of 17 (41%) who showed signal-intensity loss on gradient-echo. The increased frequency of detection using SWI versus gradient-echo is statistically significant (z = 2.85, P < .01; χ(2) = 8.10, P < .01). Six of the lesions showed signal-intensity changes on T1 and/or T2 whereas the remaining lesions were isointense to normal brain.
  
  
  CONCLUSIONS
  Brain capillary telangiectasias are more conspicuous on SWI than gradient-echo imaging and other precontrast MR imaging. SWI is a valuable tool in diagnosing these benign lesions and should serve to increase diagnostic confidence.
authors.affiliation: From the Department of Radiology (U.S.C., D.E.D., B.A.P.).
authors.forename: U S
authors.initials: US
authors.lastname: Chaudhry
authors.affiliation: From the Department of Radiology (U.S.C., D.E.D., B.A.P.) Section of Neuroradiology (D.E.D., B.A.P.), University of Iowa Hospitals and Clinics, Iowa City, Iowa.
authors.forename: D E
authors.initials: DE
authors.lastname: De Bruin
authors.affiliation: From the Department of Radiology (U.S.C., D.E.D., B.A.P.) Section of Neuroradiology (D.E.D., B.A.P.), University of Iowa Hospitals and Clinics, Iowa City, Iowa. bruno-policeni@uiowa.edu.
authors.forename: B A
authors.initials: BA
authors.lastname: Policeni
mesh_terms: D000328:Adult; D000368:Aged; D001921:Brain / Q000473:pathology; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000473:pathology; D003287:Contrast Media; D017352:Echo-Planar Imaging; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; D019786:Gadolinium DTPA