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TOPIC OF THE ISSUE: NEUROIMAGE
Year : 2010  |  Volume : 58  |  Issue : 4  |  Page : 618-619

Susceptibility-weighted imaging in capillary telangiectasia


Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum-695 011, Kerala, India

Date of Acceptance01-Jan-2010
Date of Web Publication24-Aug-2010
Date of Print Publicaton23-Aug-2010

Correspondence Address:
Hima S Pendharkar
Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum 695011, Kerala
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0028-3886.68671

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How to cite this article:
Pendharkar HS, Thomas B, Gupta AK. Susceptibility-weighted imaging in capillary telangiectasia. Neurol India 2010;58:618-9

How to cite this URL:
Pendharkar HS, Thomas B, Gupta AK. Susceptibility-weighted imaging in capillary telangiectasia. Neurol India [serial online] 2010 [cited 2019 Oct 14];58:618-9. Available from: http://www.neurologyindia.com/text.asp?2010/58/4/618/68671


A 54-year old female presented with acute onset of dysphagia with nasal regurgitation and dysarthria of two weeks duration. She had in addition vertigo with tinnitus in the right ear since six months and mild weakness of the right hand grip since six weeks. On examination, there was mild left ptosis with gaze evoked nystagmus. Pain, temperature, vibration and position sense were impaired on the right face. Right ninth and tenth cranial nerves were also involved. There was mild spasticity in the right upper and lower limbs, grade 4+/5 power and brisk deep tendon reflexes. Right cerebellar signs were positive in the upper limb. Magnetic resonance imaging (MRI) of the brain revealed a left medullary cavernoma [Figure 1]a-d with pontine capillary telangiectasia [Figure 2]a and b.

Capillary telangiectasias (CT) are clinically asymptomatic lesions, commonly located in the pons. [1] On T2-weighted image it appears as fluffy hyper intensities, while on contrast enhanced T1-weighted image it is seen characteristically as a bunch of small vessels converging on a collector vein. [2] Susceptibility weighted image (SWI), however, demonstrates CT exquisitely without the need for contrast. [3] It also demonstrates cavernous malformation (CM) as areas of profound blooming. Identification of CT on SWI promotes to look for a coexistent CM or a developmental venous anomaly which is responsible for the symptoms of the patient. Our image adds to the limited literature on SWI features in CT. [4] SWI sequence should be incorporated in routine MR imaging to avoid the cost of contrast and also save the imaging time, without compromising diagnostic efficacy in any way.
Figure 1 : Axial images at the level of upper medulla show the cavernoma with recent bleed: (a) T1-weighted image, (b) T2-weighted image hetero intense mass with blood fluid level, (c) Contrast enhanced T1-weighted image does not show any enhancing component, (d) Susceptibility weighted image shows profound blooming of the lesion

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Figure 2 : (a) Contrast enhanced T1-weighted image shows multiple fine vessels draining to the prominent linear collector vein. (b) Susceptibility weighted image demonstrates the same angioarchitechture of the pontine capillary telangiectasia

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  Acknowledgment Top


The authors wish to thank the Director, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India for his kind permission in bringing out this report.

 
  References Top

1.Graves VB, Duff TA. Intracranial arteriovenous malformations: current imaging and treatment. Invest Radiol 1990;25:952-60.  Back to cited text no. 1  [PUBMED]    
2.Barr RM, Dillon WP, Wilson CB. Slow-flow vascular malformations of the pons: capillary telangiectasias. AJNR Am J Neuroradiol 1996;17:71-8.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]  
3.Haddar D, Haacke E, Sehgal V, Delproposto Z, Salamon G, Seror O, et al. Susceptibility-weighted imaging. Theory and application. J Radiol 2004;85:1901-8.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]  
4.Yoshida Y, Terae S, Kudo K, Tha KK, Imamura M, Miyasaka K. Capillary telangiectasia of the brain stem diagnosed by susceptibility-weighted imaging. J Comput Assist Tomogr 2006;30:980-2.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]  


    Figures

  [Figure 1], [Figure 2]

This article has been cited by
1 Susceptibility-weighted MR imaging for diagnosis of capillary telangiectasia of the brain
El-Koussy, M. and Schroth, G. and Gralla, J. and Brekenfeld, C. and Andres, R.H. and Jung, S. and Shahin, M.A. and Lovblad, K.O. and Kiefer, C. and Kottke, R.
American Journal of Neuroradiology. 2012; 33(4): 715-720
[Pubmed]
2 Susceptibility-Weighted MR Imaging for Diagnosis of Capillary Telangiectasia of the Brain
M. El-Koussy,G. Schroth,J. Gralla,C. Brekenfeld,R. H. Andres,S. Jung,M. A. Shahin,K. O. Lovblad,C. Kiefer,R. Kottke
American Journal of Neuroradiology. 2012; 33(4): 715
[Pubmed] | [DOI]



 

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