MRI features of spinal intramedullary cavernous hemangiomas

To study the magnetic resonance imaging (MRI) features of spinal intramedullary cavernous hemangiomas (SICHs), we reviewed MR images of 5 patients (3 males and 2 females; age range: 18-54 years) with histologically proven spinal intramedullary cavernous hemangiomas. The MR images were obtained at 1.5 tesla and analyzed with respect to signal intensities and contrast enhancement patterns of the lesions. The locations of the lesions were cervical in 1 patient, thoracic in 2, and cervicothoracic in 2. One lesion showed high signal intensities, 1 showed isointensity, and 3 showed mixed high and low signal intensities on T1-weighted images. On T2-weighted images, 4 lesions showed high signal intensity with surrounding hypointensity, and 1 lesion revealed faint high signal intensity. One lesion revealed expansion of the spinal cord. After gadolinium-DTPA administration, strong enhancement was seen in 1 lesion and mild in another. In conclusion, SICH has characteristic MRI findings of mixed hyper- and hypointensities which allow early recognition of this rare vascular malformation as well as early treatment that can prevent further neurological deterioration.