O'Lynnger Thomas M, Al-Holou Wajd N, Gemmete Joseph J, Pandey Aditya S, Thompson B Gregory, Garton Hugh J L, Maher Cormac O
Department of Neurosurgery, University of Michigan, Ann Arbor, MI, 48109-5338, USA.
Childs Nerv Syst. 2011 Aug;27(8):1273-9. doi: 10.1007/s00381-011-1434-9. Epub 2011 Mar 26.
Arteriovenous malformations (AVMs) are the most frequently encountered structural cause of spontaneous intracerebral hemorrhage in childhood, excluding hemorrhages of prematurity. The goal of our study was to examine the relationship between age and AVM prevalence on imaging in children, which to date has not been well described.
We queried the electronic and radiographic records of 14,936 consecutive patients aged 25 years or less who had undergone brain magnetic resonance imaging (MRI) at a single institution over an 11-year period to identify those with a cerebral AVM. We collected age, gender, and other demographic characteristics for all patients. For all patients with a cerebral AVM, we recorded the location, size, drainage pattern, Spetzler-Martin grade, medical history, and presence of neurological symptoms.
Cerebral AVMs were identified in 55 patients (0.37%). The prevalence of AVMs detected on MRI significantly increased with age (p = 0.001). AVMs were found in 0.34% of boys (25 of 7,447) and 0.40% of girls (30 of 7,489). AVMs were most commonly identified in the frontal lobes (36%), followed by parietal (20%) and temporal lobes (13%). Sixty percent (n = 33) of AVMs were less than 3 cm in size, 35% (n = 19) were 3-6 cm in size, and 5.5% (n = 3) were greater than 6 cm in size. As for Spetzler-Martin grade of the AVMs, 25.5% were grade I, 18.2% were grade II, 36.4% were grade III, 16.4% were grade IV, and 3.6% were grade V.
AVMs are seen more frequently on MRI with advancing age in children and young adults.
动静脉畸形（AVM）是儿童期自发性脑出血最常见的结构性病因，不包括早产相关的出血。我们研究的目的是探讨年龄与儿童影像学上AVM患病率之间的关系，迄今为止，这一关系尚未得到充分描述。
我们查询了11年间在单一机构接受脑磁共振成像（MRI）检查的14936例25岁及以下连续患者的电子和影像学记录，以确定患有脑AVM的患者。我们收集了所有患者的年龄、性别和其他人口统计学特征。对于所有患有脑AVM的患者，我们记录了病变位置、大小、引流模式、斯佩茨勒-马丁分级、病史和神经症状的存在情况。
共识别出55例脑AVM患者（0.37%）。MRI检测到的AVM患病率随年龄显著增加（p = 0.001）。在男孩中，AVM的检出率为0.34%（7447例中的25例），在女孩中为0.40%（7489例中的30例）。AVM最常见于额叶（36%），其次是顶叶（20%）和颞叶（13%）。60%（n = 33）的AVM大小小于3 cm，35%（n = 19）为3 - 6 cm，5.5%（n = 3）大于6 cm。至于AVM的斯佩茨勒-马丁分级，25.5%为I级，18.2%为II级，36.4%为III级，16.4%为IV级，3.6%为V级。
在儿童和年轻人中，随着年龄增长，MRI上更频繁地发现AVM。
