Division of Radiology, Department of Pathophysiological and Therapeutic Science.
AJNR Am J Neuroradiol. 2013 Oct;34(10):1940-4. doi: 10.3174/ajnr.A3495. Epub 2013 Apr 18.
The risk of hemorrhage in the context of developmental venous anomaly is considered to be very low, but it has never been evaluated by susceptibility-weighted MR imaging at 3T. The goal of the present study was to evaluate the prevalence of hypointense foci (ie, microhemorrhage or cavernous malformation) associated with DVA on phase-sensitive MR imaging, on the basis of principles similar to those of susceptibility-weighted MR imaging, and to evaluate the relationship between the hypointense foci and several factors, such as white matter hyperintense lesions adjacent to DVA on T2-weighted imaging, DVA morphology, and clinical symptoms.
This study retrospectively evaluated 61 lesions in 59 consecutive patients with DVA who underwent MR imaging including phase-sensitive MR imaging. Two neuroradiologists independently assessed for the presence of hypointense foci and other factors such as DVA location, depth, size, direction of draining vein on phase-sensitive MR imaging, and white matter hyperintense lesion on T2-weighted imaging. Clinical symptoms were also assessed.
Hypointense foci were observed in 62.3% (38/61) of lesions. White matter hyperintense lesion was more frequently observed in patients with hypointense foci (26/38) than in patients without hypointense foci (7/23) (P < .01). There was no significant association between hypointense foci and other factors.
Our results support the hypothesis that microhemorrhage or cavernous malformation can be related to venous congestion caused by abnormal venous drainage. We conclude that phase-sensitive MR imagingis useful for the detection of microhemorrhage or cavernous malformation in patients with DVA, especially when associated with white matter hyperintense lesion.
尽管发育性静脉异常(developmental venous anomaly,DVA)出血的风险较低,但尚未通过 3T 下的磁共振敏感加权成像(susceptibility-weighted MR imaging,SWI)进行评估。本研究的目的是基于与 SWI 相似的原理,通过相位敏感磁共振成像(phase-sensitive MR imaging,PS-MRI)评估与 DVA 相关的低信号灶(即微出血或海绵状血管畸形)的发生率,并评估低信号灶与多种因素之间的关系,如 T2 加权成像上与 DVA 相邻的脑白质高信号病变、DVA 形态和临床症状。
本回顾性研究纳入了 59 例连续 DVA 患者的 61 个病灶,这些患者均接受了包括 PS-MRI 在内的 MRI 检查。两名神经放射科医生独立评估低信号灶的存在以及其他因素,如 DVA 的位置、深度、大小、PS-MRI 上引流静脉的方向和 T2 加权成像上的脑白质高信号病变。还评估了临床症状。
61 个病灶中有 62.3%(38/61)观察到低信号灶。在有低信号灶的患者(26/38)中更常观察到脑白质高信号病变,而在无低信号灶的患者(7/23)中则较少观察到(P<.01)。低信号灶与其他因素之间无显著相关性。
本研究结果支持微出血或海绵状血管畸形可能与异常静脉引流引起的静脉淤血相关的假说。我们得出结论,PS-MRI 有助于发现 DVA 患者的微出血或海绵状血管畸形,尤其是当伴有脑白质高信号病变时。