The value of T(2)(*)-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.