Cavernoma

Cavernoma-A-Axi-T1WI.jpg

A

Cavernoma-B-Axi-T2WI.jpg

B

Cavernoma-C-Axi-T1+C.jpg

C

Cavernoma-D-Cor-T1+C.jpg

D

Clinical History: 
This 35-year-old woman presented to neurology clinic with a one week history of increasing confusion and new-onset seizures. Following MRI illustrated here, the patient underwent surgical treatment for the lesion illustrated herein.

Diagnosis:
Right frontal lobe cavernous malformation.

MR Technique: 
Scans were acquired at 1.5 T utilizing an 8-channel head coil. (A) Axial pre-contrast spin echo T1-weighted (TR/TE 375/14 ms, 320×192 matrix) and (B) fast spin echo T2-weighted (TR/TE 4000/107 ms) images were acquired, in addition to (C) axial and (D) coronal post-contrast spin echo T1-weighted images. Scans were obtained with a slice thickness of 5 mm.

Imaging Findings:
T2WI demonstrate the classic “popcorn” appearance associated with cavernous hemangiomas, referring specifically to the central area of mixed signal intensity and caused in part by the prominence of vascular structures within the lesion. Surrounding hypointensity correlates with hemosiderin that has been deposited into surrounding tissues secondary to recurrent, chronic hemorrhage. Although hypointense on pre-contrast T1-weighted images, post-contrast scans demonstrate lesion enhancement secondary to gadolinium chelate accumulation within the lesion’s sinusoidal vascular structures.