Ruíz Diego San Millán, Yilmaz Hasan, Gailloud Philippe
Division of Interventional and Diagnostic Neuroradiology, Geneva University Hospital, Geneva, Switzerland.
Ann Neurol. 2009 Sep;66(3):271-83. doi: 10.1002/ana.21754.
Cerebral developmental venous anomalies are the most frequently encountered cerebral vascular malformation, and as such, are frequently reported as fortuitous findings in computed tomography (CT) and magnetic resonance imaging (MRI) studies. Developmental venous anomalies (DVAs) are generally considered extreme anatomical variations of the cerebral vasculature, and follow a benign clinical course in the vast majority of cases. Here we review current concepts on DVAs with the aim of helping clinicians understand this complex entity. Morphological characteristics that are necessary to conceptualize DVAs are discussed in depth. Images modalities used in diagnosing DVAs are reviewed, including new MRI or CT techniques. Clinical presentation, association with other vascular malformations and cerebral parenchymal abnormalities, and possible physiopathological processes leading to associated imaging or clinical findings are discussed. Atypical forms of DVAs are also reviewed and their clinical significance discussed. Finally, recommendations as to how to manage asymptomatic or symptomatic patients with a DVA are advanced.
脑发育性静脉异常是最常见的脑血管畸形，因此，在计算机断层扫描（CT）和磁共振成像（MRI）研究中经常作为偶然发现被报道。发育性静脉异常（DVA）通常被认为是脑血管系统的极端解剖变异，在绝大多数情况下呈良性临床过程。在此，我们回顾关于DVA的当前概念，旨在帮助临床医生理解这一复杂实体。深入讨论了概念化DVA所需的形态学特征。回顾了用于诊断DVA的影像模式，包括新的MRI或CT技术。讨论了临床表现、与其他血管畸形和脑实质异常的关联，以及导致相关影像或临床发现的可能病理生理过程。还回顾了DVA的非典型形式并讨论了其临床意义。最后，提出了关于如何处理无症状或有症状DVA患者的建议。
