Susceptibility-Weighted Imaging for the Evaluation of Large Cavernous Malformation: A Case Report

磁化率加權影像用於評估大型海綿狀畸形：病例報告

陳建宇(Chien-Yu Chen) ； 張裕綱(Yu-Kang Chang) ； 蕭睦樺(Mu-Hua Hsiao) ； 李健逢(Chien-Feng Li) ； 陳威宇(Wei-Yu Chen)

《中華放射線醫學雜誌》 35卷1期 (2010/03) Pp. 21-26

摘要

大型海綿狀畸形的診斷是具有挑戰性的，因為它的影像表現多變。我們報告一個22歲男性在左邊顳葉有一個大腫瘤。電腦斷層發現一個有病灶周圍水腫之高密度腫瘤在左邊顳葉。囊狀成份，一小鈣化點及部分病灶顯影也被注意到。在核磁共振影像之下，這個腫瘤的大小大約是4.9×4.0×4.2公分。在T1加權影像可見腫瘤內出血。腫瘤周圍的低訊號邊緣可見於T2加權影像且在磁化率加權影像表現更清楚。經外科切除後，病理確認了海綿狀畸形的診斷。磁化率加權影像是一種利用不同組織間磁化率差異的技術。因為它對於區別血液、鐵質及鈣化有高度的敏感性，所以可以用來幫助診斷海綿狀畸形在腦出血的病人。

並列摘要

The diagnosis of a large cavernous malformation may be challenging because its imaging appearance is variable. Here we reported a 22-year-old man with a large mass in left side temporal lobe. Computed tomography showed a high density intra-axial mass with perifocal edema in left side temporal lobe. Cystic component, a tiny calcified spot and partial contrast enhancement of this lesion were also noted. Magnetic resonance imaging disclosed this mass was measured about 4.9 × 4.0 ×4.2 cm in size. Intra-tumoral hemorrhage was noted on T1-weighted images. On T2-weighted images, the peripheral hypointense rim around this mass was shown, which also appeared clearly on susceptibility-weighted images. Surgical excision was performed and pathology confirmed the diagnosis of cavernous malformation. Susceptibility-weighted imaging is a magnetic resonance technique that exploits the magnetic susceptibility differences of various tissues, such as blood, iron and calcification. Because of its high degree of sensitivity in identifying venous structures and blood products, it can help to confirm the diagnosis of cavernous malformation in patients presenting with cerebral hemorrhage.