Diagnosis and differential diagnosis of intracranial vascular malformations using proton spin tomography

Abstract

Eleven patients are described, nine of whom had angiomas and two/had aneurysms in the brain. Magnetic resonance tomography produced characteristic findings in all these patients. Angiomas typically show irregular margins with little or no surrounding oedema. Thrombosis is common and can be recognised by a reduction of T1 and prolongation of T2. Zones with high blood flow show reduced signal strength. In typical cases the lesion resembles a cauliflower. Enlarged draining veins could be recognised in five of the nine angiomas. Aneurysms, on the other hand, have a smooth configuration and it may be possible to demonstrate their connection to the vessels; signals arising from them are more homogeneous and less speckled. Their signal may be increased, reduced or absent, depending on blood flow. Angiomas and aneurysms may be associated with intracerebral bleeding. Magnetic resonance tomography is markedly superior to CT in diagnosing these lesions. Unlike CT, magnetic resonance tomography does not require the use of contrast media.