Larvie M, Timerman D, Thum J A
From the Harvard Medical School (M.L.), Boston, Massachusetts Divisions of Neuroradiology and Nuclear Medicine and Molecular Imaging (M.L., D.T., J.A.T.), Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
Divisions of Neuroradiology and Nuclear Medicine and Molecular Imaging (M.L., D.T., J.A.T.), Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts Division of Health Sciences and Technology (D.T., J.A.T.), Harvard-Massachusetts Institute of Technology, Cambridge, Massachusetts.
AJNR Am J Neuroradiol. 2015 Mar;36(3):475-80. doi: 10.3174/ajnr.A4172. Epub 2014 Dec 4.
Developmental venous anomalies are the most common intracranial vascular malformation and are typically regarded as inconsequential, especially when small. While there are data regarding the prevalence of MR imaging findings associated with developmental venous anomalies, FDG-PET findings have not been well-characterized.
Clinical information systems were used to retrospectively identify patients with developmental venous anomalies depicted on MR imaging examinations who had also undergone FDG-PET. Both the MR imaging and FDG-PET scans were analyzed to characterize the developmental venous anomalies and associated findings on the structural and functional scans. Qualitative and quantitative assessments were performed, including evaluation of the size of the developmental venous anomaly, associated MR imaging findings, and characterization of the FDG uptake in the region of the developmental venous anomaly.
Twenty-five developmental venous anomalies in 22 patients were identified that had been characterized with both MR imaging and FDG-PET, of which 76% (19/25) were associated with significant metabolic abnormality in the adjacent brain parenchyma, most commonly hypometabolism. Patients with moderate and severe hypometabolism were significantly older (moderate: mean age, 65 ± 7.4 years, P = .001; severe: mean age, 61 ± 8.9 years, P = .008) than patients with developmental venous aberrancies that did not have abnormal metabolic activity (none: mean age, 29 ± 14 years).
Most (more than three-quarters) developmental venous anomalies in our series of 25 cases were associated with metabolic abnormality in the adjacent brain parenchyma, often in the absence of any other structural abnormality. Consequently, we suggest that developmental venous anomalies may be better regarded as developmental venous aberrancies.
发育性静脉异常是最常见的颅内血管畸形，通常被认为无关紧要，尤其是小型病变。虽然有关于与发育性静脉异常相关的磁共振成像（MR）表现的患病率数据，但氟代脱氧葡萄糖正电子发射断层扫描（FDG-PET）表现尚未得到充分描述。
利用临床信息系统回顾性识别在MR成像检查中显示有发育性静脉异常且同时接受了FDG-PET检查的患者。对MR成像和FDG-PET扫描进行分析，以在结构和功能扫描上对发育性静脉异常及相关表现进行特征描述。进行了定性和定量评估，包括评估发育性静脉异常的大小、相关的MR成像表现以及发育性静脉异常区域的FDG摄取特征。
在22例患者中识别出25处发育性静脉异常，这些异常均通过MR成像和FDG-PET进行了特征描述，其中76%（19/25）与相邻脑实质的显著代谢异常相关，最常见的是代谢减低。代谢中度减低和重度减低的患者比无异常代谢活动的发育性静脉异常患者明显年龄更大（中度减低：平均年龄，65±7.4岁，P = 0.001；重度减低：平均年龄，61±8.9岁，P = 0.008）（无异常代谢活动：平均年龄，29±14岁）。
在我们的25例病例系列中，大多数（超过四分之三）发育性静脉异常与相邻脑实质的代谢异常相关，且通常不存在任何其他结构异常。因此，我们建议发育性静脉异常可能更好地被视为发育性静脉变异。
