Fact-sheet: Capillary telangiectasia
Updated on 09/17/2021 at 12:16 PM
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Definition
According to A. Osborn, capillary telangiectasia accounts for 15 to 20% of all cerebral vascular malformations. It is located mainly in the brainstem. It is often asymptomatic and found incidentally. It is sometimes associated with other lesions such as cavernoma and developmental venous anomaly. On imaging, it manifests as mild punctate "brush-like" enhancement, sometimes associated with a transpontine vein (as in our case).
MRI
T1: usually normal, occasionally slight hypointensity
T2 and FLAIR: occasionally hyperintense (50%), flow-related sluggishness (FLAIR)
T2*: marked hypointensity +++: slow intralesional flow ==> oxyHb desaturation ==> deoxyHb
Diffusion: hypointense on b1000 with moderately elevated ADC (Finkenzeller et al.: Capillary telangiectasias of the pons. Does diffusion-weighted MR increase diagnostic accuracy?)
T1+Gado +++: mild brush-like or stippled enhancement, transpontine vein
Vascular intervention
X-Ray Angiography: not useful
Management
None
Differential diagnosis
Metastasis:
intense enhancement ++
Clinical context, associated lesions
Encephalitis, inflammatory lesion: clinical context, associated lesions, DWI
Cavernoma: no enhancement