Spinal cavernous malformations: magnetic resonance imaging and associated findings

Hegde AN, Mohan S, Tan KK, Lim CC
Correspondence: Dr Tchoyoson CC Lim, tchoyoson_lim@nni.com.sg

ABSTRACT
Introduction We reviewed the clinical features, brain and spinal cord magnetic resonance (MR) imaging findings and associated abnormalities in six patients with spinal cavernous malformations (CMs).
Methods Lesions were defined on gradient-recalled echo (GRE) images but measured on T2-weighted images performed on 1.5- and 3-tesla clinical scanners.
Results Four patients had associated multiple cranial CMs and one patient had multiple spinal CMs. All spinal CMs were predominantly hypointense on GRE images, and most were predominantly hyperintense and surrounded by hypointense edge on T2-weighted images. Other associations included asymptomatic vertebral body and splenic haemangiomas.
Conclusion We conclude that intramedullary spinal CMs typically have ‘mulberry’ or ‘popcorn’ appearances similar to those of cranial CM. The presence of associated haemangioma or familial cranial CM syndrome on MR imaging may suggest the correct diagnosis without requiring invasive investigations.

Keywords: cavernomas, cavernous malformations, familial cavernomatosis, spinal cord, venous angioma
Singapore Med J 2012; 53(9): 582–586