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AJNR - American Journal of Neuroradiology

Published ahead of print on November 26, 2007
doi: 10.3174/ajnr.A0847

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American Journal of Neuroradiology 29:494-500, March 2008
© 2008 American Society of Neuroradiology

BRAIN

A T1 Hyperintense Perilesional Signal Aids in the Differentiation of a Cavernous Angioma from Other Hemorrhagic Masses

T.J. Yun^a, D.G. Na^a, B.J. Kwon^a, H.G. Rho^c,e, S.-H. Park^b, Y.-L. Suh^d and K.-H. Chang^a

^a Department of Radiology and Institute of Radiation Medicine, Seoul National University College of Medicine, Seoul, Korea
^b Department of Pathology, Seoul National University College of Medicine, Seoul, Korea
^c Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
^d Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
^e Department of Radiology, Kunkuk University Hospital, Kunkuk University College of Medicine, Seoul, Korea

Please address correspondence to Dong Gyu Na, Department of Radiology, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul, 110-744 Korea; e-mail: dgna{at}radiol.snu.ac.kr

BACKGROUND AND PURPOSE: A cavernous angioma is a developmental vascular malformation with a high risk of hemorrhage. The purpose of this work was to retrospectively determine whether an MR sign of T1 hyperintense perilesional signal intensity is useful for the differentiation of cavernous angioma from other hemorrhagic cerebral masses.

MATERIALS AND METHODS: The institutional review board approved this study. We retrospectively evaluated the MR images of 72 patients with acute or subacute cerebral hemorrhagic lesions with perilesional edema (29 cavernous angiomas, 13 glioblastomas, 1 oligodendroglioma, 16 metastatic tumors, and 13 intracerebral hemorrhages) for the presence of T1 hyperintense perilesional signal intensity. In addition, T1 signal intensities of a perilesional edema were quantitatively analyzed. In cavernous angiomas, volumes of hemorrhagic lesions and perilesional edemas, lesion locations, presence of contrast enhancement, and time intervals between symptom onset and MR imaging were also assessed. Data were analyzed using unpaired t test or Fisher exact test.

RESULTS: T1 hyperintense perilesional signal intensity sign was found in 18 (62.1%) of 29 cavernous angiomas, in 1 (6.3%) of 16 metastases, and in 0 primary brain tumors or intracerebral hemorrhages. Sensitivity, specificity, and positive predictive value of this sign for cavernous angioma were 62%, 98%, and 95%, respectively. The perilesional T1 hyperintensity was significantly higher in cavernous angiomas (P = .045) than in normal white matter. Perilesional edema volumes were larger in cavernous angiomas with the MR sign than in cavernous angiomas without the sign (P = .009).

CONCLUSION: When the MR sign of T1 hyperintense perilesional signal intensity is present, there is a high probability of cavernous angioma being present in the brain, and this MR sign may be helpful for differentiating cavernous angioma from hemorrhagic tumors and intracerebral hemorrhages.