Marks M P, Lane B, Steinberg G K, Chang P J
Department of Diagnostic Radiology, Stanford University Medical Center, CA 94305.
Radiology. 1990 Sep;176(3):807-13. doi: 10.1148/radiology.176.3.2389040.
The most serious and frequent complication of intracranial arteriovenous malformations (AVMs) is intracranial hemorrhage. Identification of patients at greatest risk for intracranial bleeding would be beneficial. Detailed analysis of vascular architecture was performed in 65 patients with intracranial AVMs to identify the vascular characteristics that correlated with hemorrhage. Fifteen characteristics were assessed. Hemorrhage was present in 45 patients (69%). The following characteristics correlated positively with hemorrhage (Fisher-Irwin exact test): central venous drainage (P less than .0001), periventricular or intraventricular location of the AVM (P = .0002), and intranidal aneurysm (P = .028). The following characteristics correlated negatively with hemorrhage: angiomatous change (P = .0005), peripheral venous drainage (P = .005), and mixed venous drainage (P = .021). Multivariate linear discriminant analysis demonstrated that central venous drainage, angiomatous change (negatively predictive), intranidal aneurysm, and periventricular or intraventricular location of the AVM were the most discriminating or predictive characteristics of hemorrhage. Detailed analysis of the vascular architecture of intracranial AVMs helped identify features that strongly correlate with clinical hemorrhage and have important prognostic implications for the treatment of patients with these lesions.
颅内动静脉畸形（AVM）最严重且最常见的并发症是颅内出血。识别颅内出血风险最高的患者将大有裨益。对65例颅内AVM患者的血管结构进行了详细分析，以确定与出血相关的血管特征。评估了15项特征。45例患者（69%）出现了出血情况。以下特征与出血呈正相关（Fisher-Irwin确切概率检验）：中心静脉引流（P<0.0001）、AVM位于脑室周围或脑室内（P = 0.0002）以及瘤巢内动脉瘤（P = 0.028）。以下特征与出血呈负相关：血管瘤样改变（P = 0.0005）、外周静脉引流（P = 0.005）以及混合静脉引流（P = 0.021）。多变量线性判别分析表明，中心静脉引流、血管瘤样改变（负性预测）、瘤巢内动脉瘤以及AVM位于脑室周围或脑室内是出血最具判别力或预测性的特征。对颅内AVM血管结构的详细分析有助于识别与临床出血密切相关且对这些病变患者治疗具有重要预后意义的特征。
