Huang Zheng, Peng Kang, Chen Changqing, Zeng Feiyue, Wang Junyu, Chen Fenghua
Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha, China.
Department of Radiology, Xiangya Hospital, Central South University, Changsha, China.
J Stroke Cerebrovasc Dis. 2018 Aug;27(8):2082-2087. doi: 10.1016/j.jstrokecerebrovasdis.2018.03.003. Epub 2018 Apr 2.
Brain arteriovenous malformation (BAVM) is a congenital cerebral vascular disease that characterized with intracranial hemorrhage and epilepsy. It has some risk in current treatments including microsurgery, endovascular, and radiation therapy. Some patients with bAVMs may keep unruptured in their whole life. Whether it should be treated depends on the evaluation of the hemorrhage risk of bAVM. Although previous studies gave many significant predictors, we tried to find some new and more significant predictors in 173 patients with bAVMS by retrospective analysis.
Except for previous predictors reported such as age, gender, epilepsy, location, aneurysm related with bAVM, volume of nidus, types of venous drainage, and the number of draining veins, we also collected time to peak (TTP) and sum of cross-sectional area of the feeding arteries and sum of cross-sectional area of the draining veins (∑SA/∑SV) data to proceed univariate and multivariate statistical analysis in 173 patients with bAVM.
The results of the statistical analysis show that gender, the location of bAVM nidus, and TTP are significant predictors of hemorrhage risk, but age, size, the number of draining veins, and types of venous drainage do not appear so significant. The value of predictors of bleeding risk including TTP was assessed by receiver operating characteristic curve and area under curve to be stronger.
When TTP and ∑SA/∑SV data were added, some previous important indicators such as age, size, the number of draining veins, and types of venous drainage appear less significant in predicting the hemorrhage risk of bAVM in statistics, but TTP, gender, and the location of bAVM nidus are significant; moreover, TTP is a predictor that needs to be emphasized.
脑动静脉畸形（BAVM）是一种先天性脑血管疾病，其特征为颅内出血和癫痫。当前的治疗方法（包括显微手术、血管内治疗和放射治疗）存在一定风险。一些BAVM患者可能终生未破裂。是否进行治疗取决于对BAVM出血风险的评估。尽管先前的研究给出了许多重要的预测因素，但我们通过回顾性分析，试图在173例BAVM患者中找到一些新的、更具显著性的预测因素。
除了先前报道的预测因素，如年龄、性别、癫痫、位置、与BAVM相关的动脉瘤、畸形巢体积、静脉引流类型和引流静脉数量外，我们还收集了达峰时间（TTP）、供血动脉横截面积总和与引流静脉横截面积总和（∑SA/∑SV）数据，对173例BAVM患者进行单因素和多因素统计分析。
统计分析结果显示，性别、BAVM畸形巢位置和TTP是出血风险的显著预测因素，但年龄、大小、引流静脉数量和静脉引流类型并非如此显著。通过受试者工作特征曲线和曲线下面积评估，包括TTP在内的出血风险预测因素的值更强。
当加入TTP和∑SA/∑SV数据时，一些先前重要的指标，如年龄、大小、引流静脉数量和静脉引流类型，在统计学上预测BAVM出血风险时显得不那么显著，但TTP、性别和BAVM畸形巢位置是显著的；此外，TTP是一个需要强调的预测因素。
