Cavernous angioma MRI

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]<nowiki>; Associate Editor(s)-in-Chief: Edzel Lorraine Co, D.M.D., M.D.

Overview

Diagnosis can be made through incidental findings from magnetic resonance imaging (MRI) screening. A gradient-echo sequence should be utilized to unmask punctate lesions which can go undetected. These lesions are more visible on FLAIR imaging than on T2 weighing. As compared to T2 weighing, FLAIR imaging has more suppression of free-flowing fluid signals.

Popcorn-like, smoothly circumscribed, well-delineated complex lesions.^[1]
The core is formed by multiple foci of mixed-signal intensities, which represents hemorrhage in various stages of evolution.
The heterogeneous core typically is surrounded completely by a low-signal-intensity hemosiderin rim on T1-weighted images. The hypointensity of this rim becomes more prominent, or blooms, on T2-weighted and gradient-refocused images because of the magnetic susceptibility effects.
Smaller cavernous malformations may appear as focal hypointense nodules with both T1- and T2-weighted sequences. The small lesions are depicted more clearly and are more numerous on gradient-echo images because of the increased susceptibility effects of the sequences.