The value of T2*-weighted gradient echo imaging for detection of familial cerebral cavernous malformation: A study of two families

The aim of this study was to investigate the value of T(2) (*)-weighted gradient echo imaging (GRE T(2) (*)-WI) for the detection of familial cerebral cavernous malformation (FCCM). Twenty-six members of 2 families with FCCM were examined using computed tomography (CT), conventional magnetic resonance imaging (MRI) and GRE T(2) (*)-WI sequences. We identified 12 cases of FCCM using GRE T(2) (*)-WI sequences. These 12 patients had multiple lesions (mean 23). The lesions were most commonly located in the ganglia. Other areas included the cortex-subcortex, thalamus, cerebellum and brainstem. These lesions appeared as a reticulated core of mixed signal intensity with a surrounding rim of decreased signal intensity representing hemosiderin from previous hemorrhages. The mean numbers of lesions and cases of FCCM identified by various conventional MRI sequences were 5-17 and 3-9, respectively. Conventional MRI examination involved T(1)-weighted imaging (T(1)WI), T(2)-weighted imaging (T(2)WI), T(2)-fluid-attenuated inversion recovery (T(2)Flair), diffusion-weighted imaging (DWI) and spin-echo imaging (SE) sequences, in that order. The numbers of lesions identified by MRI were fewer than those identified by GRE T(2) (*)-WI. CT only identified 3 cases with large lesions combined with hemorrhage and calcification. These findings suggest that GRE T(2) (*)-WI is the first choice when diagnosing FCCM compared with CT and conventional MRI.