CT AND MRI DIAGNOSIS OF CEREBRAL VENOUS MALFORMATION

Objective To investigate the diagnostic value of CT and MRI on cerebral venous malformations (CVM). Methods CT and MRI of eight CVM patients were analyzed retrospectively. Of whom, six underwent CT plain scans, four of them received enhancement scanning; three underwent CT angiography using MPR and VR reconstruction; three received MRI plain examination and MRI enhancement scanning; and one received 3D TOF MRA examination. Results CVMs were located infra-tentorium in five cases (four were of superficial type and one of deep type), and supra-tentorium in three patients (two were of superficial type and one of deep type). Five presented the typical “caput medusae” appearance. There were no positive findings in CT plain scans in all cases, while CT enhancement facilitated the stereo-manifestation of the draining veins and their directions, of which one presented a lake-like varix where the draining vein converged into the superior sagittal sinus and one presented the two branches of the tree-like drainage vein. As to MRI plain scans, the medullary veins showed hypointensity in T1WI and hyperintensity in T2WI, while the drainage veins featured hypointensity in T1WI and hypointensity or hyperintensity in T2WI. FLAIR sequences manifested less medullary veins with hyperintensity and thinner and shorter drainage veins with hypointensity or hyperintensity, but not so clearly and sensitively as T2WI. Both the medullary and the draining veins appeared hypointensity in DWI images. CE MRI was able to exhibit the whole structure and details of CVM in various directions, with more and longer medullary veins and better visualization of the draining vein and its orientation. There were no positive findings on MRA pictures for the very case of MRA exam. Conclusion MRI could be the first choice for suspected CVM patients. Enhancement CT or CE MRI scans are of the highest sensitivity to manifest more medullary veins and better visualization of the drainage vein and its draining orientation. 3D CTA reconstructions facilitate visualizing the whole structure of CVM.