Department of Radiology, Division of Neuroradiology, University of Massachusetts Medical Center, Worcester, Massachusetts 01655, USA.
J Neurosurg. 2010 Apr;112(4):814-23. doi: 10.3171/2009.8.JNS09586.
Cavernous malformations (CMs) can cause symptoms that appear out of proportion to the lesion size, leading one to hypothesize that they may have an effect on adjacent white matter that is not fully explained by local mass effect. The goal of this study was to investigate the diffusion tensor (DT) properties of CMs, the hemosiderin rim, and normal-appearing adjacent white matter.
Eighteen cavernous malformations were characterized using standard MR imaging sequences as well as 6-direction DT imaging with single-shot echo planar-gradient echo imaging at 3 tesla.
Diffusion tensor imaging demonstrated that CMs have a characteristic signature on DT imaging, with low fractional anisotropy (FA) and high mean diffusivity centrally within the lesion. The hemosiderin rim had a high FA value relative to the central lesion or adjacent white matter. Tractography revealed that tracts neatly deviate around CMs. Tracts were typically seen to pass through the hemosiderin rim.
The hemosiderin rim of CMs was intimately associated with white matter tracts that were deviated by the central lesion. These findings are consistent with histopathological reports that the hemosiderin rim is composed of blood breakdown products deposited in viable white matter.
海绵状血管畸形（CMs）可引起与病变大小不成比例的症状，这使人推测它们可能对相邻的白质有影响，而这种影响不能完全用局部占位效应来解释。本研究的目的是研究海绵状血管畸形、含铁血黄素环和正常相邻白质的弥散张量（DT）特性。
在 3 特斯拉场强下，使用标准磁共振成像序列和单次激发回波平面梯度回波成像进行 6 个方向的 DT 成像，对 18 个海绵状血管畸形进行了特征描述。
弥散张量成像显示，CMs 在 DT 成像上具有特征性表现，病变中央的部分各向异性分数（FA）低，平均弥散度高。含铁血黄素环的 FA 值相对高于中央病变或相邻白质。示踪成像显示，束径在 CMs 周围整齐地偏离。束径通常穿过含铁血黄素环。
CMs 的含铁血黄素环与被中央病变偏离的白质束密切相关。这些发现与组织病理学报告一致，即含铁血黄素环是由沉积在存活白质中的血液分解产物组成的。
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