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OtherBrain

MR Spectroscopy in the Diagnosis of Cerebral Amyloid Angiopathy Presenting as a Brain Tumor

Yair Safriel, Gordon Sze, Kaye Westmark and Joachim Baehring
American Journal of Neuroradiology November 2004, 25 (10) 1705-1708;
Yair Safriel
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Gordon Sze
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Kaye Westmark
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Joachim Baehring
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    Fig 1.

    Imaging of CAA/ACNS at presentation and after 9 months of therapy with pathologic correlation.

    A, FLAIR coronal image shows increased signal intensity with mass effect on the adjacent sulci and lateral ventricles in the right occipitotemporal region.

    B, Diffusion-weighted axial image shows no restricted diffusion.

    C, T1-weighted axial contrast-enhanced image shows decreased signal intensity without contrast enhancement.

    D, Probe-press, single voxel (2 cm3 [TE = 135]) centered on the region of abnormality shows normal spectra and ratios.

    E, Hematoxylin and eosin slide shows a blood vessel (arrow) with surrounding inflammation and multinucleated giant cells (arrowheads).

    F, Immunohistochemistry with a beta-amyloid specific antibody demarcates the vessel wall (arrowheads). Both vessels are surrounded by a mononuclear inflammatory infiltrate (hematoxylin counter-stain).

    G, FLAIR coronal image obtained 9 months after presentation shows significant resolution of previously seen tumafactive lesion in the right occipitotemporal region.

    H, FLAIR axial image obtained 9 months after presentation shows increased signal intensity in the right and left temporal regions (arrows).

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    Fig 2.

    Multi-modality imaging of CAA at presentation and after treatment with pathologic correlation.

    A, Noncontrast CT scan from 1999 shows decreased attenuation with sulcal effacement and mass effect on the occipital horn of the lateral ventricle.

    B, T2-weighted axial image also from 1999 shows increased signal intensity with mass effect on the adjacent sulci and the right lateral ventricle.

    C, Diffusion-weighted axial image shows no restricted diffusion.

    D, T1-weighted axial contrast-enhanced image shows decreased signal intensity without enhancement.

    E, Probe-press single voxel (2 cm3 [TE = 135]) centered on the region of abnormality shows normal spectra and ratios.

    F, T2-weighted axial image obtained in 2000 shows near-complete resolution of right occipital abnormality with a small residual area of encephalomalacia at the biopsy site.

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  • Previous case reports with MR imaging of CAA and CAA/ACNS

    SeriesPathologyContrast EnhancementLocationAgeSexAntecedent Event
    Vandermissen et al (3)CAANoSupratentorial, abuts ependyma46 recurred @ 59MICH
    Osumi et al (4)CAANoSupratentorial, abuts ependyma56 recurred @ 59FSeizure
    Ortiz and Reed (5)CAANoSupratentorial, abuts ependyma68F
    SafrielCAANoSupratentorial, abuts ependyma71F‘Stroke’
    SafrielCAA/ACNSNoSupratentorial, abuts ependyma48M
    Tamargo et al (6)CAA/ACNSSlightMultiple supratentorial, abuts ependyma80F
    Polivka et al (7)CAA/ACNSNoSupratentorial, abuts dura60M
    Polivka et al (7)CAA/ACNSNoSupratentorial, abuts dura74F
    Fountain and Eberhard (8)CAA/ACNSNoMultiple supratentorial, abuts ependyma66MICH
    • Note.—Caa, cerebral amyloid angiopathy; ACNS, angitis of the central nervous system; ICH, intracranial hemorrhage.

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American Journal of Neuroradiology: 25 (10)
American Journal of Neuroradiology
Vol. 25, Issue 10
1 Nov 2004
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Cite this article
Yair Safriel, Gordon Sze, Kaye Westmark, Joachim Baehring
MR Spectroscopy in the Diagnosis of Cerebral Amyloid Angiopathy Presenting as a Brain Tumor
American Journal of Neuroradiology Nov 2004, 25 (10) 1705-1708;

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MR Spectroscopy in the Diagnosis of Cerebral Amyloid Angiopathy Presenting as a Brain Tumor
Yair Safriel, Gordon Sze, Kaye Westmark, Joachim Baehring
American Journal of Neuroradiology Nov 2004, 25 (10) 1705-1708;
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  • Pseudotumoral presentation of cerebral amyloid angiopathy-related inflammation
  • Good Outcome in a Patient Treated for Cerebral Amyloid Angiopathy Presenting as an Expansive Process with Inflammation and Contrast Enhancement
  • Cerebral amyloid angiopathy related inflammation: three case reports and a review
  • Tumour-like mass lesion: an under-recognised presentation of primary angiitis of the central nervous system
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