Pinker Katja, Stavrou Ioannis, Knosp Engelbert, Trattnig Siegfried
Department of Radiology/MR Centre of Excellence, Medical University Vienna/General Hospital Vienna, 1090 Vienna, Austria.
Magn Reson Imaging. 2006 Jun;24(5):631-7. doi: 10.1016/j.mri.2005.10.037. Epub 2006 Feb 13.
The aim of this study was to determine whether cerebral cavernomas are truly nonenhancing lesions on magnetic resonance imaging (MRI), whether they can be distinguished from arteriovenous malformations (AVM) on that basis and to evaluate the incidence of their association with developmental venous anomalies (DVA).
Thirty-two patients who underwent neurosurgical operation for a cerebral vascular malformation and had a standard MRI conclusive of cerebral cavernoma were retrospectively evaluated for size of the lesions, contrast enhancement of the lesion and the coexistence of DVA. The contrast uptake of these lesions was investigated, and contrast enhancement was classified as none, moderate or marked. The incidence of an associated DVA was also investigated. The radiological findings were subsequently correlated with neurohistopathological findings.
No difference was found between the contrast enhancement of cavernomas and AVMs. Cross tables were calculated for contrast enhancement and size, which demonstrated no statistically significant correlation. Cross tables were calculated for contrast enhancement and histopathological diagnosis, which revealed that both entities presented variable degrees of contrast enhancement and were thereby not distinguishable from each other on the basis of contrast enhancement. We found an association of cavernoma with DVA in 30% of cases.
Neither a correlation between the absence of contrast enhancement and the histopathological diagnosis of cavernoma nor the size and contrast enhancement was found. We conclude that cavernomas present with variable degrees of contrast enhancement on MRI and, thus, are definitely not distinguishable from AVM on the basis of contrast enhanced MRI. We found an association between cavernomas and DVA in approximately one third of patients.
本研究旨在确定脑海绵状血管瘤在磁共振成像（MRI）上是否真的无强化，能否基于此与动静脉畸形（AVM）相鉴别，并评估其与发育性静脉异常（DVA）并存的发生率。
对32例因脑血管畸形接受神经外科手术且标准MRI确诊为脑海绵状血管瘤的患者，回顾性评估病变大小、病变的对比增强情况以及DVA的共存情况。研究这些病变的对比剂摄取情况，将对比增强分为无、中度或明显。还研究了相关DVA的发生率。随后将影像学结果与神经组织病理学结果进行关联分析。
海绵状血管瘤和AVM的对比增强之间未发现差异。计算了对比增强与大小的交叉表，结果显示无统计学显著相关性。计算了对比增强与组织病理学诊断的交叉表，结果表明两者均呈现不同程度的对比增强，因此无法基于对比增强将它们彼此区分开来。我们发现30%的病例中海绵状血管瘤与DVA有关联。
未发现对比增强缺失与海绵状血管瘤的组织病理学诊断之间存在相关性，也未发现大小与对比增强之间存在相关性。我们得出结论，脑海绵状血管瘤在MRI上呈现不同程度的对比增强，因此在对比增强MRI上肯定无法与AVM区分开来。我们发现约三分之一的患者中海绵状血管瘤与DVA有关联。
