Chaudhry U S, De Bruin D E, Policeni B A
From the Department of Radiology (U.S.C., D.E.D., B.A.P.).
From the Department of Radiology (U.S.C., D.E.D., B.A.P.) Section of Neuroradiology (D.E.D., B.A.P.), University of Iowa Hospitals and Clinics, Iowa City, Iowa.
AJNR Am J Neuroradiol. 2014 Dec;35(12):2302-5. doi: 10.3174/ajnr.A4082. Epub 2014 Aug 21.
Enhancing lesions on brain MR imaging can present a diagnostic quandary as both benign lesions such as brain capillary telangiectasia and pathologic lesions such as demyelination may appear similar. Stagnation of blood in low-flow venous channels of brain capillary telangiectasias results in susceptibility effect secondary to the increased local deoxyhemoglobin. Both T2* gradient-echo imaging and SWI were demonstrated as valuable in the diagnosis of brain capillary telangiectasia. Because SWI is more sensitive to susceptibility changes than gradient-echo, we aim to demonstrate increased diagnostic value of SWI compared with gradient-echo in making the diagnosis of brain capillary telangiectasia.
We retrospectively reviewed the MR images of 17 patients with a presumed diagnosis of brain capillary telangiectasia and who were examined from June 2010 to September 2012. All patients underwent MR imaging at 1.5T with T1, T2, FLAIR, gradient-echo, SWI, and gadolinium-enhanced T1 sequences. Lesions were evaluated for the presence or absence of signal abnormality on each particular sequence.
All 17 brain capillary telangiectasias demonstrated distinct signal-intensity loss on SWI compared with 7 of 17 (41%) who showed signal-intensity loss on gradient-echo. The increased frequency of detection using SWI versus gradient-echo is statistically significant (z = 2.85, P < .01; χ(2) = 8.10, P < .01). Six of the lesions showed signal-intensity changes on T1 and/or T2 whereas the remaining lesions were isointense to normal brain.
Brain capillary telangiectasias are more conspicuous on SWI than gradient-echo imaging and other precontrast MR imaging. SWI is a valuable tool in diagnosing these benign lesions and should serve to increase diagnostic confidence.
脑部磁共振成像（MR）上的强化病变可能带来诊断难题，因为诸如脑毛细血管扩张症这类良性病变和诸如脱髓鞘这类病理性病变可能表现相似。脑毛细血管扩张症低血流静脉通道中的血液停滞会导致局部脱氧血红蛋白增加继发的磁化率效应。T2*梯度回波成像和磁敏感加权成像（SWI）均已被证明在脑毛细血管扩张症的诊断中具有价值。由于SWI对磁化率变化比梯度回波更敏感，我们旨在证明与梯度回波相比，SWI在脑毛细血管扩张症的诊断中具有更高的诊断价值。
我们回顾性分析了2010年6月至2012年9月间17例疑似脑毛细血管扩张症患者的MR图像。所有患者均在1.5T磁场下接受了T1、T2、液体衰减反转恢复序列（FLAIR）、梯度回波、SWI及钆增强T1序列的MR成像检查。评估病变在每个特定序列上是否存在信号异常。
与17例中有7例（41%）在梯度回波上出现信号强度丢失相比，所有17例脑毛细血管扩张症在SWI上均表现出明显的信号强度丢失。使用SWI检测到病变的频率增加与梯度回波相比具有统计学意义（z = 2.85，P < 0.01；χ(2)= 8.10，P < 0.01）。6个病变在T1和/或T2上出现信号强度变化，而其余病变与正常脑实质等信号。
脑毛细血管扩张症在SWI上比梯度回波成像及其他对比前MR成像更明显。SWI是诊断这些良性病变的一种有价值的工具，应有助于提高诊断信心。
