Linscott L L, Leach J L, Zhang B, Jones B V
From the Departments of Radiology (L.L.L., J.L.L., B.V.J.)
From the Departments of Radiology (L.L.L., J.L.L., B.V.J.).
AJNR Am J Neuroradiol. 2014 Aug;35(8):1600-7. doi: 10.3174/ajnr.A3960. Epub 2014 May 15.
Abnormal signal in the drainage territory of developmental venous anomalies has been well described in adults but has been incompletely investigated in children. This study was performed to evaluate the prevalence of brain parenchymal abnormalities subjacent to developmental venous anomalies in children and young adults, correlating with subject age and developmental venous anomaly morphology and location.
Two hundred eighty-five patients with developmental venous anomalies identified on brain MR imaging with contrast, performed from November 2008 through November 2012, composed the study group. Data were collected for the following explanatory variables: subject demographics, developmental venous anomaly location, morphology, and associated parenchymal abnormalities. Associations between these variables and the presence of parenchymal signal abnormalities (response variable) were then determined.
Of the 285 subjects identified, 172 met inclusion criteria, and among these subjects, 193 developmental venous anomalies were identified. Twenty-six (13.5%) of the 193 developmental venous anomalies had associated signal-intensity abnormalities in their drainage territory. After excluding developmental venous anomalies with coexisting cavernous malformations, we obtained an adjusted prevalence of 21/181 (11.6%) for associated signal-intensity abnormalities in developmental venous anomalies. Signal-intensity abnormalities were independently associated with younger subject age, cavernous malformations, parenchymal atrophy, and deep venous drainage of developmental venous anomalies.
Signal-intensity abnormalities detectable by standard clinical MR images were identified in 11.6% of consecutively identified developmental venous anomalies. Signal abnormalities are more common in developmental venous anomalies with deep venous drainage, associated cavernous malformation and parenchymal atrophy, and younger subject age. The pathophysiology of these signal-intensity abnormalities remains unclear but may represent effects of delayed myelination and/or alterations in venous flow within the developmental venous anomaly drainage territory.
发育性静脉异常引流区域的异常信号在成人中已有充分描述，但在儿童中研究尚不完整。本研究旨在评估儿童和青年中发育性静脉异常下方脑实质异常的发生率，并与受试者年龄、发育性静脉异常的形态和位置相关联。
2008年11月至2012年11月期间进行的脑磁共振成像增强检查中确诊为发育性静脉异常的285例患者组成研究组。收集以下解释变量的数据：受试者人口统计学信息、发育性静脉异常的位置、形态以及相关的脑实质异常。然后确定这些变量与脑实质信号异常（反应变量）之间的关联。
在确诊的285例受试者中，172例符合纳入标准，在这些受试者中，共发现193个发育性静脉异常。193个发育性静脉异常中有26个（13.5%）在其引流区域存在相关的信号强度异常。排除合并海绵状畸形的发育性静脉异常后，发育性静脉异常相关信号强度异常的校正患病率为21/181（11.6%）。信号强度异常与受试者年龄较小、海绵状畸形、脑实质萎缩以及发育性静脉异常的深静脉引流独立相关。
在连续确诊的发育性静脉异常中，11.6%可通过标准临床磁共振图像检测到信号强度异常。信号异常在具有深静脉引流、合并海绵状畸形和脑实质萎缩以及受试者年龄较小的发育性静脉异常中更为常见。这些信号强度异常的病理生理学尚不清楚，但可能代表发育性静脉异常引流区域髓鞘形成延迟和/或静脉血流改变的影响。
