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Miracle of medical imaging: Why is MRI the best tool for diagnosing CCM?
The brain cavernous hemangioma (CCM) is a cavernous hemangioma that occurs in the central nervous system. This type of lesions is characterized by large blood vessels and a large number of venous channels, which have round belly and thin walls, and are usually filled with slow-moving blood. The diameter of CCM can range from a few millimeters to a few centimeters, mainly occur in the brain, but may also affect other organs. The lesion has a variety of clinical manifestations, which may include recurrent headaches, local nerve defects, and even hemorrhagic stroke. In some cases, CCM may not have any obvious symptoms.
Most cases are asymptomatic, which means that this lesion may not be diagnosed promptly in many patients.
Symptoms and Diagnosis of CCM
Due to the different depth structure of CCM infection, the nature and severity of symptoms vary. The preferred tool for diagnosing CCM is magnetic resonance imaging (MRI), especially when scanning using specific gradient echo sequences. This technique can reveal small or punctate lesions that may be overlooked in other tests. In addition, CCM lesions will be more obvious in FLAIR imaging.
MRI can not only help doctors see the lesions, but also stumble upon asymptomatic CCM while looking for other pathology.
Genetics of CCM
The family inheritance form of CCM is associated with three known genomic loci. These three genes encode KRIT1, malcavernin and PDCD10, respectively. Mutations in these genes are considered to be the main pathogenic factor of cavernous hemangioma in the brain, which is caused by about 70% to 80% of cases. The study pointed out that there may also be a fourth gene, CCM4, whose mutations can also lead to the occurrence of CCM, which means that CCM may have other genetic factors that have not been identified.
Imaging Applications in Diagnosis
Generally speaking, doctors rely on MRI for diagnosis, which reveal potential CCM when regular MRI examinations reveal meaningless lesions. In addition, CT scans are more effective for the detection of bleeding, so CT scans are usually given priority in the case of suspected bleeding stroke. If the appearance of the lesion cannot be determined on an MRI, a neurosurgeon may require cerebral angiography.
CCM is a low-flow lesion, so it is often difficult to detect in angiography, which makes professional medical imaging technology particularly important.
Treatment Choice and Future Challenges
The only effective treatment for symptomatic CCM is currently surgery, depending on the location of the lesion. There are currently no medications for CCM, and the success of the surgery often depends on the adequate preoperative diagnosis. Therefore, ensuring timely and precise imaging tests is key.
Overall, the incidence of cavernous hemangioma in the brain is about 0.5%, and clinical symptoms usually occur between the ages of 20 and 30. These vascular lesions can be spontaneous or exhibit autosomal dominant genetic characteristics. With the rapid development of imaging technology, we may be able to expect that the diagnosis and treatment will be more accurate in the future.
With the advancement of medical technology, can we find more effective ways to diagnose and treat CCM to reduce the pain in patients?
