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The venous angioarchitecture of sporadic cerebral cavernous malformations: a susceptibility weighted imaging study at 7 T MRI
  1. Philipp Dammann1,2,
  2. Karsten H Wrede1,2,
  3. Stefan Maderwald2,
  4. Nicolai El Hindy1,
  5. Oliver Mueller1,
  6. Bixia Chen1,
  7. Yuan Zhu1,
  8. Bernd-Otto Hütter1,
  9. Mark E Ladd2,3,
  10. Marc Schlamann3,
  11. I Erol Sandalcioglu1,
  12. Ulrich Sure1
  1. 1Department of Neurosurgery, University Hospital Essen, Essen, Germany
  2. 2Erwin L Hahn Institute for Magnetic Resonance Imaging, University of Duisburg-Essen, UNESCO-World Cultural Heritage Zollverein, Essen, Germany
  3. 3Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
  1. Correspondence to P Dammann, Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, Essen 45122, Germany; philipp.dammann{at}uk-essen.de

Abstract

Background and purpose To test the hypothesis that sporadic cerebral cavernous malformations (CCMs) are systematically associated with venous malformations (VMs) using susceptibility weighted imaging (SWI) at 7 Tesla (T) field MRI.

Methods A prospective unselected series of 20 patients with symptomatic or asymptomatic sporadic CCM diagnosed using 1.5 T MRI was additionally scanned using high resolution (250 µm2 in-plane) SWI at 7 T MRI. Imaging data were analysed to examine the presence and formation of CCM associated venous vessel structures. Interobserver agreement was assessed using kappa statistics.

Results In the 20 patients harbouring 23 CCMs, a solitary or multiple venous drainage was found in all lesions. A ‘typical’ VM was found in seven lesions. In the other cases, associated abnormal venous structures were also depicted although they appeared structurally different. Excellent interobserver agreement was achieved (95% confidence interval 0.92 to 0.99).

Conclusions Our data support previous assumptions that sporadic CCMs are systematically associated with local venous abnormalities involving larger outflow vessels. However, the typical appearance of a VM was not confirmed in all cases. The role of the venous environment in the pathomechanism of CCMs remains unclear.

  • MRI
  • Vascular Surgery
  • Stroke
  • Neuroradiology
  • Neurosurgery

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