Vessel wall imaging and quantitative flow assessment in arteriovenous malformations: A feasibility study.

IF 1.7 4区医学 Q3 Medicine

Interventional Neuroradiology Pub Date : 2024-10-01 Epub Date: 2022-12-05 DOI:10.1177/15910199221143189

Laura Stone McGuire, Mark Rizko, Denise Brunozzi, Fady T Charbel, Ali Alaraj

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引用次数: 0

Abstract

Introduction: Cerebral arteriovenous malformations (AVMs) carry a rupture rate of 2-3% per year. Several architectural factors may influence rupture rate, and a recently theorized model of AVMs describes the influence of vessel wall inflammation. A novel imaging modality, vessel wall imaging (VWI), has been developed to view inflammatory processes in vessel wall foci but has not yet been examined in AVMs, which is the aim of this study.

Methods: This retrospective review studies prospectively collected data on patients with ruptured and unruptured AVMs between 2019 and 2021. Inclusion criteria included adult patients (≥18 years) with radiographically diagnosed AVM who underwent VWI. Charts were reviewed for medical history, clinical presentation, hospital course, discharge condition, and follow-up. Angioarchitectural features, blood flow, and VWI were compared in patients with and without hemorrhagic patients.

Results: Nine patients underwent VWI, mean age 37.7 ± 9.9 years. Four presented with hemorrhage (44.4%). Seven (77.7%) received glue embolization and 6 (66.7%) underwent surgical resection. All patients (4/4) with a history of hypertension presented with hemorrhage (p = 0.0027). Size and Spetzler-Martin grade were not associated with hemorrhage (p = 0.47, p = 0.59). Net AVM flow was higher in patients presenting with hemorrhage, although nonsignificant (p = 0.19). With VWI, 3 (75%) hemorrhagic AVMs showed visible nidus and draining veins, and all three demonstrated positive post-contrast wall enhancement in at least one of their draining veins; conversely, of fivenonhemorrhagic AVMs, only 2 (40%) demonstrated post-contrast wall enhancement in any draining vein (p = 0.090).

Conclusion: This pilot study successfully demonstrated capture of venous walls in AVMs using VWI. In this study, draining vein enhancement occurred more often in hemorrhagic AVM and in those with higher venous volumetric flow.

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动静脉畸形的血管壁成像和定量血流评估：可行性研究

简介：脑动静脉畸形（AVM）每年的破裂率为 2-3%：脑动静脉畸形（AVM）的破裂率为每年 2-3%。有几种结构因素可能会影响破裂率，最近提出的 AVM 模型描述了血管壁炎症的影响。血管壁成像（VWI）是一种新型成像方式，用于观察血管壁病灶的炎症过程，但尚未对 AVM 进行研究，这正是本研究的目的所在：这项回顾性研究前瞻性地收集了 2019 年至 2021 年期间破裂和未破裂 AVM 患者的数据。纳入标准包括经放射学诊断为 AVM 并接受 VWI 的成年患者（≥18 岁）。审查病历以了解病史、临床表现、住院过程、出院情况和随访情况。比较了有出血患者和无出血患者的血管结构特征、血流量和 VWI：九名患者接受了血管造影，平均年龄（37.7 ± 9.9）岁。四名患者出现出血（44.4%）。7名患者（77.7%）接受了胶栓塞治疗，6名患者（66.7%）接受了手术切除。所有有高血压病史的患者（4/4）都出现了出血（p = 0.0027）。大小和 Spetzler-Martin 分级与出血无关（p = 0.47，p = 0.59）。出现出血的患者 AVM 净流量较高，但并不显著（p = 0.19）。通过 VWI，3 个（75%）出血性 AVM 显示出可见的瘤巢和引流静脉，并且这 3 个 AVM 至少有一条引流静脉显示出造影后正壁强化；相反，在非出血性 AVM 中，只有 2 个（40%）显示出任何引流静脉的造影后正壁强化（p = 0.090）：这项试验性研究成功地利用 VWI 捕获了 AVM 的静脉壁。在这项研究中，引流静脉增强更常发生在出血性 AVM 和静脉容积流量较高的 AVM 中。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Interventional Neuroradiology 医学-核医学

CiteScore

2.80

自引率

11.80%

发文量

192

审稿时长

6-12 weeks

期刊介绍： Interventional Neuroradiology (INR) is a peer-reviewed clinical practice journal documenting the current state of interventional neuroradiology worldwide. INR publishes original clinical observations, descriptions of new techniques or procedures, case reports, and articles on the ethical and social aspects of related health care. Original research published in INR is related to the practice of interventional neuroradiology...