case_images: PMC10899325_01
case_images: Magnetic susceptibility dependent axial images acquired at 1.5T and 7T and Quantitative Susceptibility (chi) Mapping analysis. While in the 1.5T images the foci of deposition (hypointense in all sequences) appear to be located at the cortico medullary junction, it is worth noting that in 7T images they appeared located in intracortical area as confirmed in images detail (panel on the right).
case_images: fneur-15-1362704-g0001.jpg
case_images: PMC10899325_01_fneur-15-1362704-g0001.jpg
case_images: F1
case_images: T2-weighted and susceptibility-weighted images improved the spatial localization of the T2*-hypointense signal alterations. Indeed, many lesions which appeared at the level of the corticomedullary junction in 1.5 T images were judged as intracortical in 7T images (Figure 1). Moreover, the dominant susceptibility source of the lesions was identified by using QSM, thus distinguishing small and round alterations with high susceptibility values, probably referring to radio-induced vascular malformations or microbleeds, in this case iuxtacortical, from intracortical diamagnetic alterations with a gyriform pattern, probably referring to mineralizing microangiopathies. The latter were probably caused by the combination of CT and RT treatment which caused calcium deposits and subsequently mineralizing microangiopathies (Figure 2).
case_images: Magnetic susceptibility dependent sequence Quantitative Susceptibility (chi) Mapping (QSM) at 1.5T and 7T. Several focal hypointense formations are visible at the cortico-medullary junction in the two cerebral hemispheres (white circles), more numerous and evident in 7T images. Some of them (red circles) are hyperintense in the QSM images in in relation to the presence of material with high magnetic susceptibility, thus probably referring to radio-induced cryptic vascular malformations (cavernomas, capillary telangiectasias). Others (blue circles) remain hypointense in QSM images due to the prevailing presence of diamagnetic material, thus probably referring to parenchymal calcifications as a complication of multimodal chemo-radiotherapy treatment.
case_images: fneur-15-1362704-g0002.jpg
case_images: PMC10899325_01_fneur-15-1362704-g0002.jpg
case_images: F2
case_images: T2-weighted and susceptibility-weighted images improved the spatial localization of the T2*-hypointense signal alterations. Indeed, many lesions which appeared at the level of the corticomedullary junction in 1.5 T images were judged as intracortical in 7T images (Figure 1). Moreover, the dominant susceptibility source of the lesions was identified by using QSM, thus distinguishing small and round alterations with high susceptibility values, probably referring to radio-induced vascular malformations or microbleeds, in this case iuxtacortical, from intracortical diamagnetic alterations with a gyriform pattern, probably referring to mineralizing microangiopathies. The latter were probably caused by the combination of CT and RT treatment which caused calcium deposits and subsequently mineralizing microangiopathies (Figure 2).