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Hsu CCT, Krings T. Symptomatic Developmental Venous Anomaly: State-of-the-Art Review on Genetics, Pathophysiology, and Imaging Approach to Diagnosis. AJNR Am J Neuroradiol 2023; 44:498-504. [PMID: 36997285 PMCID: PMC10171382 DOI: 10.3174/ajnr.a7829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Accepted: 02/23/2023] [Indexed: 04/01/2023]
Abstract
Developmental venous anomalies (DVAs) are the most common slow-flow venous malformation in the brain. Most DVAs are benign. Uncommonly, DVAs can become symptomatic, leading to a variety of different pathologies. DVAs can vary significantly in size, location, and angioarchitecture, and imaging evaluation of symptomatic developmental venous anomalies requires a systematic approach. In this review, we aimed to provide neuroradiologists with a succinct overview of the genetics and categorization of symptomatic DVAs based on the pathogenesis, which forms the foundation for a tailored neuroimaging approach to assist in diagnosis and management.
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Affiliation(s)
- C C-T Hsu
- From the Division of Neuroradiology (C.C.-T.H.), Department of Medical Imaging, Gold Coast University Hospital, Southport, Queensland, Australia
- Division of Neuroradiology (C.C.-T.H.), Lumus Imaging, Varsity Lakes, Queensland, Australia
| | - T Krings
- Division of Neuroradiology (T.K.), Department of Medical Imaging, Toronto Western Hospital; University Medical Imaging Toronto and University of Toronto, Ontario, Canada
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Akyel NG, Alımlı AG, Sivri M, Akmaz Ünlü H, Tiftik M. Diagnostic Accuracy of SWAN in the Diagnosis of Low-Flow Brain Vascular Malformations in Childhood. JOURNAL OF PEDIATRIC NEUROLOGY 2021. [DOI: 10.1055/s-0041-1736554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Abstract
Purpose The main objective of this study is to demonstrate the diagnostic accuracy of susceptibility-weighted angiography (SWAN) in the diagnosis of slow-flow cerebral vascular malformations, especially developmental venous anomaly (DVA). We also aimed to determine the prevalence of DVAs identified by SWAN at 1.5 T.
Methods We retrospectively evaluated 1,760 axial SWAN images for the diagnosis of low-flow vascular anomaly. Among them were 305 patients who underwent contrast-enhanced examination due to different indications. Postcontrast images were analyzed by different radiologists who were blinded to patients. The presence of DVA and other features such as location, length, depth, and direction of drainage vein was evaluated.
Results Twenty-six patients with DVA had both SWAN and postcontrast images. There were four false-negative patients with SWAN. The sensitivity of the SWAN sequence was 84.6%. In addition, totally 77 DVA (4.36%), 2 capillary telangiectasia (0.11%), and 2 cavernous malformations (0.11%) were detected in 1,760 patients.
Conclusion SWAN is an effective method for the diagnosis of developmental venous anomalies and other low-flow cerebral vascular malformations. Especially in the pediatric age, susceptibility-weighted imaging sequences are useful to limit contrast use.
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Affiliation(s)
- Nazlı Gülsüm Akyel
- Department of Pediatric Radiology, Sanliurfa Training and Research Hospital, Şanlıurfa, Turkey
| | - Ayşe Gül Alımlı
- Department of Pediatric Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Mesut Sivri
- Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Havva Akmaz Ünlü
- Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Mehmet Tiftik
- Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
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Geraldo AF, Messina SS, Tortora D, Parodi A, Malova M, Morana G, Gandolfo C, D'Amico A, Herkert E, Govaert P, Ramenghi LA, Rossi A, Severino M. Neonatal Developmental Venous Anomalies: Clinicoradiologic Characterization and Follow-Up. AJNR Am J Neuroradiol 2020; 41:2370-2376. [PMID: 33093132 DOI: 10.3174/ajnr.a6829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 08/06/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Although developmental venous anomalies have been frequently studied in adults and occasionally in children, data regarding these entities are scarce in neonates. We aimed to characterize clinical and neuroimaging features of neonatal developmental venous anomalies and to evaluate any association between MR imaging abnormalities in their drainage territory and corresponding angioarchitectural features. MATERIALS AND METHODS We reviewed parenchymal abnormalities and angioarchitectural features of 41 neonates with developmental venous anomalies (20 males; mean corrected age, 39.9 weeks) selected through a radiology report text search from 2135 neonates who underwent brain MR imaging between 2008 and 2019. Fetal and longitudinal MR images were also reviewed. Neurologic outcomes were collected. Statistics were performed using χ2, Fisher exact, Mann-Whitney U, or t tests corrected for multiple comparisons. RESULTS Developmental venous anomalies were detected in 1.9% of neonatal scans. These were complicated by parenchymal/ventricular abnormalities in 15/41 cases (36.6%), improving at last follow-up in 8/10 (80%), with normal neurologic outcome in 9/14 (64.2%). Multiple collectors (P = .008) and larger collector caliber (P < .001) were significantly more frequent in complicated developmental venous anomalies. At a patient level, multiplicity (P = .002) was significantly associated with the presence of ≥1 complicated developmental venous anomaly. Retrospective fetal detection was possible in 3/11 subjects (27.2%). CONCLUSIONS One-third of neonatal developmental venous anomalies may be complicated by parenchymal abnormalities, especially with multiple and larger collectors. Neuroimaging and neurologic outcomes were favorable in most cases, suggesting a benign, self-limited nature of these vascular anomalies. A congenital origin could be confirmed in one-quarter of cases with available fetal MR imaging.
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Affiliation(s)
- A F Geraldo
- From the Neuroradiology Unit (A.F.G.), Centro Hospitalar de Vila Nova de Gaia/Espinho, Vila Nova de Gaia, Portugal.,Neuroradiology Unit (A.F.G., D.T., G.M., A.R., M.S.)
| | - S S Messina
- Radiology Unit (S.S.M.), Casa di Cura Regina Pacis, Palermo, Italy
| | - D Tortora
- Neuroradiology Unit (A.F.G., D.T., G.M., A.R., M.S.)
| | - A Parodi
- Neonatal Intensive Care Unit (A.P., M.M., L.A.R.)
| | - M Malova
- Neonatal Intensive Care Unit (A.P., M.M., L.A.R.)
| | - G Morana
- Neuroradiology Unit (A.F.G., D.T., G.M., A.R., M.S.)
| | - C Gandolfo
- Interventional Unit (C.G.), IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - A D'Amico
- Dipartimento di Scienze Biomediche Avanzate (A.D.), Universita' Federico II, Napoli, Italy
| | - E Herkert
- Division of Neonatology (E.H., P.G.), Department of Paediatrics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - P Govaert
- Division of Neonatology (E.H., P.G.), Department of Paediatrics, Erasmus University Medical Centre, Rotterdam, the Netherlands
| | - L A Ramenghi
- Neonatal Intensive Care Unit (A.P., M.M., L.A.R.)
| | - A Rossi
- Neuroradiology Unit (A.F.G., D.T., G.M., A.R., M.S.)
| | - M Severino
- Neuroradiology Unit (A.F.G., D.T., G.M., A.R., M.S.)
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Abdelgawad MS, Aly RA. Value of susceptibility-weighted MR imaging (SWI) in the detection of developmental venous anomaly. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2020. [DOI: 10.1186/s43055-020-00216-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Abstract
Background
Developmental venous anomaly (DVA) is probably the most common anomaly of the intracranial vasculature. DVAs consist of multiple, radially oriented dilated medullary veins that converge into a transcerebral vein. Susceptibility-weighted imaging (SWI) is a high spatial resolution 3D gradient-echo MRI sequence with phase post-processing that accentuates the paramagnetic properties of blood products such as deoxyhemoglobin, intracellular methemoglobin, and hemosiderin. Its high sensitivity to hemorrhagic particles by means of susceptibility dephasing effects within the veins allow for the accurate detection, grading, and monitoring of brain venous anomalies. In this review, we evaluated the prevalence of the brain DVAs identified by SWI in many patients who had undergone magnetic resonance imaging (MRI) with contrast administration. All images were independently reviewed by two radiologists who were blinded to other MR imaging finding. It is hoped that as SWI becomes more widely available, it will provide additional diagnostic and prognostic information that will improve the care and outcome of patients with DVAs.
Results
A total of 29 DVAs were observed with its prevalence 2.8%. The DVA caputs had mostly deep localization in about 44.8% of our DVA cases. SWI proved excellent demonstration of DVAs with the sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were significantly higher than the other non-contrast MR sequences. On SWI, DVA is delineated as a signal void lesion with the normal cerebral veins.
Conclusion
Susceptibility-weighted imaging (SWI) is valuable in the diagnosis of DVA and should be included in routine MR assessment of the brain.
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Choi Y, Jang J, Nam Y, Shin NY, Choi HS, Jung SL, Ahn KJ, Kim BS. Relationship between Abnormal Hyperintensity on T2-Weighted Images Around Developmental Venous Anomalies and Magnetic Susceptibility of Their Collecting Veins: In-Vivo Quantitative Susceptibility Mapping Study. Korean J Radiol 2019; 20:662-670. [PMID: 30887748 PMCID: PMC6424825 DOI: 10.3348/kjr.2018.0685] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 12/31/2018] [Indexed: 11/20/2022] Open
Abstract
Objective A developmental venous anomaly (DVA) is a vascular malformation of ambiguous clinical significance. We aimed to quantify the susceptibility of draining veins (χvein) in DVA and determine its significance with respect to oxygen metabolism using quantitative susceptibility mapping (QSM). Materials and Methods Brain magnetic resonance imaging of 27 consecutive patients with incidentally detected DVAs were retrospectively reviewed. Based on the presence of abnormal hyperintensity on T2-weighted images (T2WI) in the brain parenchyma adjacent to DVA, the patients were grouped into edema (E+, n = 9) and non-edema (E−, n = 18) groups. A 3T MR scanner was used to obtain fully flow-compensated gradient echo images for susceptibility-weighted imaging with source images used for QSM processing. The χvein was measured semi-automatically using QSM. The normalized χvein was also estimated. Clinical and MR measurements were compared between the E+ and E− groups using Student's t-test or Mann-Whitney U test. Correlations between the χvein and area of hyperintensity on T2WI and between χvein and diameter of the collecting veins were assessed. The correlation coefficient was also calculated using normalized veins. Results The DVAs of the E+ group had significantly higher χvein (196.5 ± 27.9 vs. 167.7 ± 33.6, p = 0.036) and larger diameter of the draining veins (p = 0.006), and patients were older (p = 0.006) than those in the E− group. The χvein was also linearly correlated with the hyperintense area on T2WI (r = 0.633, 95% confidence interval 0.333–0.817, p < 0.001). Conclusion DVAs with abnormal hyperintensity on T2WI have higher susceptibility values for draining veins, indicating an increased oxygen extraction fraction that might be associated with venous congestion.
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Affiliation(s)
- Yangsean Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jinhee Jang
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
| | - Yoonho Nam
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Na Young Shin
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyun Seok Choi
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - So Lyung Jung
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kook Jin Ahn
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Bum Soo Kim
- Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Young A, Poretti A, Bosemani T, Goel R, Huisman TAGM. Sensitivity of susceptibility-weighted imaging in detecting developmental venous anomalies and associated cavernomas and microhemorrhages in children. Neuroradiology 2017; 59:797-802. [DOI: 10.1007/s00234-017-1867-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Accepted: 06/14/2017] [Indexed: 11/29/2022]
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Ma M, Chen JY, Plowey ED, Fischbein N, Iv M. Tumefactive demyelination associated with developmental venous anomaly: Report of two cases. Clin Imaging 2017; 43:194-198. [PMID: 28364723 DOI: 10.1016/j.clinimag.2017.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 02/25/2017] [Indexed: 11/18/2022]
Abstract
We present two cases of tumefactive demyelination (TD) occurring in close association with a developmental venous anomaly (DVA). Our purpose is to describe the association between demyelinating lesions and venous anomalies, as only one case of TD associated with a DVA has been published in the literature. Appropriate recognition of this "do not touch" lesion may avoid invasive and potentially harmful procedures such as biopsy or resection.
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Affiliation(s)
- Mingming Ma
- Department of Radiology, Stanford University Medical Center, Stanford, CA, United States.
| | - James Y Chen
- Department of Radiology, University of California San Diego, San Diego, CA
| | - Edward D Plowey
- Department of Pathology, Stanford University Medical Center, Stanford, CA, United States
| | - Nancy Fischbein
- Department of Radiology, Stanford University Medical Center, Stanford, CA, United States
| | - Michael Iv
- Department of Radiology, Stanford University Medical Center, Stanford, CA, United States
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Nabavizadeh SA, Mamourian AC, Vossough A, Loevner LA, Hurst R. The Many Faces of Cerebral Developmental Venous Anomaly and Its Mimicks: Spectrum of Imaging Findings. J Neuroimaging 2016; 26:463-72. [DOI: 10.1111/jon.12373] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2016] [Revised: 05/18/2016] [Accepted: 05/19/2016] [Indexed: 12/01/2022] Open
Affiliation(s)
- Seyed Ali Nabavizadeh
- Department of Radiology, Hospital of University of Pennsylvania; Perelman School of Medicine of the University of Pennsylvania; Philadelphia PA
| | - Alexander C. Mamourian
- Department of Radiology, Hospital of University of Pennsylvania; Perelman School of Medicine of the University of Pennsylvania; Philadelphia PA
| | - Arastoo Vossough
- Division of Neuroradiology, Children's Hospital of Philadelphia; Perelman School of Medicine of the University of Pennsylvania; Philadelphia PA
| | - Laurie A. Loevner
- Department of Radiology, Hospital of University of Pennsylvania; Perelman School of Medicine of the University of Pennsylvania; Philadelphia PA
| | - Robert Hurst
- Department of Radiology, Hospital of University of Pennsylvania; Perelman School of Medicine of the University of Pennsylvania; Philadelphia PA
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Li X, Wang Y, Chen W, Wang W, Chen K, Liao H, Lu J, Li Z. Intracerebral hemorrhage due to developmental venous anomalies. J Clin Neurosci 2016; 26:95-100. [DOI: 10.1016/j.jocn.2015.06.031] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2015] [Revised: 06/18/2015] [Accepted: 06/20/2015] [Indexed: 10/22/2022]
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Linscott LL, Leach JL, Jones BV, Abruzzo TA. Developmental venous anomalies of the brain in children -- imaging spectrum and update. Pediatr Radiol 2016; 46:394-406; quiz 391-3. [PMID: 26795616 DOI: 10.1007/s00247-015-3525-3] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2015] [Accepted: 11/26/2015] [Indexed: 11/25/2022]
Abstract
Developmental venous anomalies (DVAs) are the most common vascular malformation of the brain and are commonly identified on routine imaging of the brain. They are typically considered incidental findings, usually with no clinical significance. However the increasing identification of DVAs as a result of improved imaging technology has led to recognition of their association with a variety of abnormal imaging findings and clinically important conditions. This pictorial essay explores the suspected embryological origin, associated imaging features, and proposed pathophysiological mechanisms of DVAs in the pediatric population. This paper emphasizes newer physiological imaging data, which suggest that DVA drainage has less physiological flexibility than otherwise normal venous drainage development.
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Affiliation(s)
- Luke L Linscott
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA.
| | - James L Leach
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA
| | - Blaise V Jones
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA
| | - Todd A Abruzzo
- Department of Radiology, University of Cincinnati College of Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., Cincinnati, OH, 45229, USA
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Jones BV, Linscott L, Koberlein G, Hummel TR, Leach JL. Increased Prevalence of Developmental Venous Anomalies in Children with Intracranial Neoplasms. AJNR Am J Neuroradiol 2015; 36:1782-5. [PMID: 26021620 DOI: 10.3174/ajnr.a4352] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2015] [Accepted: 02/05/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Developmental venous anomalies are considered variants of venous development that, in and of themselves, are of little clinical import. A possible association between intrinsic brain tumors and developmental venous anomalies has been suggested, but a rigorous investigation has not been performed. The aim of this study was to assess any association between developmental venous anomalies and intrinsic brain neoplasms. MATERIALS AND METHODS A radiology report text search of terms used to describe developmental venous anomalies was performed on a study population of 580 patients with primary intracranial neoplasms and on a control population of 580 patients without neoplasms from the same time period. All positive results were reviewed to confirm that the report was describing a developmental venous anomaly, and the imaging examination was reviewed to confirm the diagnosis. RESULTS Fifty-nine of the 580 subjects with brain tumors (10.17%) had a developmental venous anomaly identified by report and confirmed on review of the imaging. Thirty-one of the 580 controls (5.34%) had a developmental venous anomaly identified by report and confirmed on review of the imaging (P = .003). No statistically significant difference was noted in the prevalence of developmental venous anomalies among tumor types. No developmental venous anomaly drained the vascular territory of the tumor, and there was no correlation between the location of the developmental venous anomaly and the location of the neoplasm. CONCLUSIONS The prevalence of developmental venous anomalies in this pediatric population with intracranial primary neoplasms is significantly greater than in those without neoplasms, suggesting an association that may be related to shared causative factors or susceptibilities to the development of these 2 separate entities.
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Affiliation(s)
- B V Jones
- From the Department of Radiology (B.V.J., L.L., G.K., J.L.L.)
| | - L Linscott
- From the Department of Radiology (B.V.J., L.L., G.K., J.L.L.)
| | - G Koberlein
- From the Department of Radiology (B.V.J., L.L., G.K., J.L.L.)
| | - T R Hummel
- Division of Pediatric Oncology (T.R.H.), Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - J L Leach
- From the Department of Radiology (B.V.J., L.L., G.K., J.L.L.)
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Blei F. Update September 2014. Lymphat Res Biol 2014. [DOI: 10.1089/lrb.2014.1232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Linscott LL, Leach JL, Zhang B, Jones BV. Brain parenchymal signal abnormalities associated with developmental venous anomalies in children and young adults. AJNR Am J Neuroradiol 2014; 35:1600-7. [PMID: 24831595 DOI: 10.3174/ajnr.a3960] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Abnormal signal in the drainage territory of developmental venous anomalies has been well described in adults but has been incompletely investigated in children. This study was performed to evaluate the prevalence of brain parenchymal abnormalities subjacent to developmental venous anomalies in children and young adults, correlating with subject age and developmental venous anomaly morphology and location. MATERIALS AND METHODS Two hundred eighty-five patients with developmental venous anomalies identified on brain MR imaging with contrast, performed from November 2008 through November 2012, composed the study group. Data were collected for the following explanatory variables: subject demographics, developmental venous anomaly location, morphology, and associated parenchymal abnormalities. Associations between these variables and the presence of parenchymal signal abnormalities (response variable) were then determined. RESULTS Of the 285 subjects identified, 172 met inclusion criteria, and among these subjects, 193 developmental venous anomalies were identified. Twenty-six (13.5%) of the 193 developmental venous anomalies had associated signal-intensity abnormalities in their drainage territory. After excluding developmental venous anomalies with coexisting cavernous malformations, we obtained an adjusted prevalence of 21/181 (11.6%) for associated signal-intensity abnormalities in developmental venous anomalies. Signal-intensity abnormalities were independently associated with younger subject age, cavernous malformations, parenchymal atrophy, and deep venous drainage of developmental venous anomalies. CONCLUSIONS Signal-intensity abnormalities detectable by standard clinical MR images were identified in 11.6% of consecutively identified developmental venous anomalies. Signal abnormalities are more common in developmental venous anomalies with deep venous drainage, associated cavernous malformation and parenchymal atrophy, and younger subject age. The pathophysiology of these signal-intensity abnormalities remains unclear but may represent effects of delayed myelination and/or alterations in venous flow within the developmental venous anomaly drainage territory.
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Affiliation(s)
- L L Linscott
- From the Departments of Radiology (L.L.L., J.L.L., B.V.J.)
| | - J L Leach
- From the Departments of Radiology (L.L.L., J.L.L., B.V.J.)
| | - B Zhang
- Biostatistics and Epidemiology (B.Z.); Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - B V Jones
- From the Departments of Radiology (L.L.L., J.L.L., B.V.J.)
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14
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Umino M, Maeda M, Matsushima N, Matsuura K, Yamada T, Sakuma H. High-signal-intensity abnormalities evaluated by 3D fluid-attenuated inversion recovery imaging within the drainage territory of developmental venous anomalies identified by susceptibility-weighted imaging at 3 T. Jpn J Radiol 2014; 32:397-404. [PMID: 24793590 DOI: 10.1007/s11604-014-0322-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2014] [Accepted: 04/16/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE To evaluate brain parenchymal high-signal-intensity abnormalities within the drainage territory of developmental venous anomalies (DVAs) identified by susceptibility-weighted imaging (SWI) at 3 T. METHODS One hundred and thirty patients with 137 DVAs identified by SWI were retrospectively studied. 3D fluid-attenuated inversion recovery (FLAIR) images were reviewed for parenchymal high-signal-intensity abnormalities and SWI images were reviewed for hypointense foci (microhemorrhages or cavernous malformations) adjacent to DVAs. Patient age, the degree of underlying white matter disease, DVA location (supratentorial or infratentorial), and the presence or absence of hypointense foci were compared across DVAs with and without high-signal-intensity abnormalities. The correlation between patient age and the size of any high-signal-intensity abnormality was analyzed using linear regression. RESULTS Forty-two of 137 DVAs (30.7 %) had high-signal-intensity abnormalities. An adjusted prevalence of 18/71 (25.4 %) was obtained after excluding patients with considerable underlying white matter disease. Only DVA location (supratentorial) was associated with the presence of high-signal-intensity abnormalities (p < 0.05). There was a significant correlation between patient age and the size of high-signal-intensity abnormalities (p < 0.01). CONCLUSIONS 3D FLAIR imaging permits detection of small high-signal-intensity abnormalities within the drainage territory of DVAs. The size of high-signal-intensity abnormalities increased with patient age.
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Affiliation(s)
- Maki Umino
- Department of Radiology, Mie University School of Medicine, 2-174 Edobashi, Tsu, Mie, 514-5807, Japan,
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15
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Jung HN, Kim ST, Cha J, Kim HJ, Byun HS, Jeon P, Kim KH, Kim BJ, Kim HJ. Diffusion and perfusion MRI findings of the signal-intensity abnormalities of brain associated with developmental venous anomaly. AJNR Am J Neuroradiol 2014; 35:1539-42. [PMID: 24651815 DOI: 10.3174/ajnr.a3900] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Developmental venous anomalies are the most common intracranial vascular malformation. Increased signal-intensity on T2-FLAIR images in the areas drained by developmental venous anomalies are encountered occasionally on brain imaging studies. We evaluated diffusion and perfusion MR imaging findings of the abnormally high signal intensity associated with developmental venous anomalies to describe their pathophysiologic nature. MATERIALS AND METHODS We retrospectively reviewed imaging findings of 34 subjects with signal-intensity abnormalities associated with developmental venous anomalies. All subjects underwent brain MR imaging with contrast and diffusion and perfusion MR imaging. Regions of interest were placed covering abnormally high signal intensity around developmental venous anomalies on fluid-attenuated inversion recovery imaging, and the same ROIs were drawn on the corresponding sections of the diffusion and perfusion MR imaging. We measured the apparent diffusion coefficient, relative cerebral blood volume, relative mean transit time, and time-to-peak of the signal-intensity abnormalities around developmental venous anomalies and compared them with the contralateral normal white matter. The Mann-Whitney U test was used for statistical analysis. RESULTS The means of ADC, relative cerebral blood volume, relative mean transit time, and TTP of signal-intensity abnormalities around developmental venous anomalies were calculated as follows: 0.98 ± 0.13 10(-3)mm(2)/s, 195.67 ± 102.18 mL/100 g, 16.74 ± 7.38 seconds, and 11.65 ± 7.49 seconds, respectively. The values of normal WM were as follows: 0.74 ± 0.08 10(-3)mm(2)/s for ADC, 48.53 ± 22.85 mL/100 g for relative cerebral blood volume, 12.12 ± 4.27 seconds for relative mean transit time, and 8.35 ± 3.89 seconds for TTP. All values of ADC, relative cerebral blood volume, relative mean transit time, and TTP in the signal-intensity abnormalities around developmental venous anomalies were statistically higher than those of normal WM (All P < .001, respectively). CONCLUSIONS The diffusion and perfusion MR imaging findings of the signal-intensity abnormalities associated with developmental venous anomaly suggest that the nature of the lesion is vasogenic edema with congestion and delayed perfusion.
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Affiliation(s)
- H N Jung
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - S T Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| | - J Cha
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H J Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H S Byun
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - P Jeon
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - K H Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - B-J Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - H-J Kim
- From the Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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