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Quantified flow and angioarchitecture show similar associations with hemorrhagic presentation of brain arteriovenous malformations - 15/02/22

Doi : 10.1016/j.neurad.2022.01.061 
Chung-Jung Lin , a, b , Ko-Kung Chen a, Yong-Sin Hu b, c, Huai-Che Yang c, d, Chun-Fu Lin c, d, Feng-Chi Chang a, b
a Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan 
b School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan 
c Department of Radiology, Taipei Veterans General Hospital Taoyuan Branch, Taoyuan, Taiwan 
d Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan 

Corresponding author at: Department of Radiology, Taipei Veterans General Hospital No. 201, Shipai Rd., Sec. 2, Beitou District, Taipei 112, Taiwan.Department of RadiologyTaipei Veterans General Hospital No. 201Shipai Rd., Sec. 2, Beitou District, Taipei 112Taiwan
En prensa. Pruebas corregidas por el autor. Disponible en línea desde el Tuesday 15 February 2022

Abstract

Introduction

The purpose of our study was to elucidate the impact of brain arteriovenous malformation (BAVM) flow and wall shear stress (WSS) on angioarchitecture and to evaluate their association with hemorrhagic presentations.

Materials and methods

Forty-one patients with BAVMs were evaluated by phase-contrast MR angiography. Volume flow rate and WSS were quantified. Angioarchitectural features such as location, angiogenesis, venous stenosis, venous ectasia, venous phlebitis, venous rerouting, exclusive deep vein and venous sac were evaluated by two neuroradiologists. The correlation between BAVM flow and size was evaluated with Spearman correlation coefficients. Differences of size, flow, and WSS between the hemorrhagic and non-hemorrhagic groups, the seizure and non-seizure groups, and between the different groups based on angioarchitecture were evaluated with Mann-Whitney U tests. Accuracy in predicting hemorrhage was evaluated with receiver operating characteristic curves.

Result

BAVM flow was highly correlated with volume (ρ = 0.77). Higher flow was more commonly associated with angiogenesis, venous ectasia, venous rerouting, and venous phlebitis. Flow and angioarchitecture showed similar efficacy in differentiating hemorrhagic from non-hemorrhagic BAVMs. WSS did not demonstrate differences across any clinical groups.

Conclusion

Flow quantification and angioarchitecture analysis of BAVMs showed similar efficacy as evaluated by associations with hemorrhagic presentation. High flow affects both arterial and venous angioarchitecture, reflecting the nature of low vascular resistance in BAVMs.

El texto completo de este artículo está disponible en PDF.

Graphical abstract




Image, graphical abstract

El texto completo de este artículo está disponible en PDF.

Highlights

Flow quantification of BAVMs outperformed nidal volumetric measurement in hemorrhagic risk assessment.
High flow affects both arterial and venous angioarchitecure, reflecting the nature of low vascular resistance in BAVMs.

El texto completo de este artículo está disponible en PDF.

Keywords : Angioarchitecture, Brain arteriovenous malformation, Flow, Size, Wall shear stress

Abbreviations : BAVM, DSA, WSS


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