Is Arterial Spin Labeling necessarily low perfusion for cavernous sinus venous malformation? A case of hyperperfusion cavernous sinus venous malformation: a case report.

Abstract

Abstract Generally, due to the influence of the skull base bone and gas, it is difficult to differentiate the imaging manifestations of extracerebral cavernous malformation and meningiomas in the cavernous sinus area. Cavernous sinus venous malformation is characterized by increased capillary masses without a direct arterial supply, typically leading to low perfusion. On the other hand, meningiomas receive arterial blood supply to the tumor and often exhibit high perfusion.Therefore, Arterial Spin Labeling (ASL) can be helpful in distinguishing between the two tumor types. However, in our specific case of a cavernous sinus venous malformation, ASL imaging showed hyperperfusion. Further analysis revealed that this hyperperfusion on ASL can occur when cavernous sinus venous malformation is associated with arteriovenous fistula malformation.