Abstract W P419: Correlation of Quantitative Susceptibility Mapping in Cerebral Cavernous Malformations with Clinical Features

Abstract

Quantitative susceptibility mapping (QSM) is a novel noninvasive magnetic resonance imaging (MRI) technique that was shown to accurately quantify the iron content in cerebral cavernous malformation (CCM) lesions. In this study, we aimed to correlate the baseline characteristics of CCM patients and their clinical activities with QSM measurements. Methods: a total of 65 patients (mean age: 39, age range: 3 - 76, 16 male, 49 female, 27 sporadic, 38 familial) were included. Imaging was performed on 3T systems. Lesions from all sporadic cases were included in the final analysis. In familial cases, only lesions identified on T2 weighted images and have maximum cross-sectional diameter greater than 5mm were included. A total of 241 lesions were analyzed. Results: Pearson’s correlation revealed that patient age at scan was positively correlated with the mean lesional susceptibility per patient (p<0.05, Figure 1a). Mean susceptibility for lesions with prior bleeding history was significantly higher than lesions without (p<0.05, Figure 1b). Longitudinal changes in lesional susceptibility were small in a short term (<14 months) in patients who were clinically stable (Figure 1c). In addition, a mixture of susceptibility levels was observed in different lesional blood byproduct depositions, as determined by contrast on the conventional MRIs (Figure 1d). Conclusions: Our prelimiary data suggested that: 1) lesions with longer duration harbor more iron; 2) lesions with prior bleeds harbor more iron deposition; 3) there are little changes in lesional iron deposition in patients who are clinically stable in a short time frame. In sum, QSM offered additional insights into the natural progression of the CCM disease in terms of the accumulation of lesional iron deposition.