Susceptibility-weighted Imaging in Diagnosing Brain Capillary Telangiectasia: a case report

Reprint requests to: Dr. Ping-Hong Lai Department of Radiology, Kaohsiung Veterans General Hospital. No. 386, Ta Chung 1st Road, Kaohsiung 813, Taiwan, R.O.C. A 65-year-old lung cancer patient was screened for intracranial metastases. Post–gadoliniumenhanced T1-weighted imaging revealed a small enhancing pontine lesion sl ightly hypointense on T2*-weighted gradient echo, invisible on T1-/ T2-weighted imaging. Susceptibil ity-weighted imaging (SWI) showed marked hypointensity; a small linear hypointensity extension suggested a draining vein. Capi l lary telangiectasia or transitional capillary-venous malformation was diagnosed. To the best of our knowledge, brain capillary telangiectasia rarely has been previously reported by SWI. Most capillary telangiectasias are in the pons, but they may also be found in the cerebral and cerebellar hemispheres and in the spinal cord. These lesions are small, usually less than 2.0 cm in diameter [1, 2]. Brain capillary telangiectasia has mild “brushlike” or “stippled” contrast material enhancement and mild hypointensity on T2*-weighted gradient echo (GRE) images [1, 2]. To the best of our knowledge, brain capillary telangiectasia has rarely been reported using susceptibility-weighted imaging (SWI) [3]. Here, we report a case of brain capillary telangiectasia or transitional capillary-venous malformation in a 65-year-old woman diagnosed by SWI.