Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, Beijing, China.
Department of Radiology, Beijing Rehabilitation Hospital, Capital Medical University, South Xixiazhuang, Shijingshan district, Beijing, China.
Sci Rep. 2024 Oct 26;14(1):25566. doi: 10.1038/s41598-024-77316-7.
This study aimed to investigate the potential correlation between the perfusion parameters of brain arteriovenous malformations (bAVMs) as determined by multiphase CT angiography and bAVM rupture. Based on the occurrence of bAVM-related hemorrhage, 480 diagnosed bAVM patients were divided into hemorrhage (n = 220) and non-hemorrhage (n = 260) groups in this retrospective multi-center study spanning 2010 to 2020. On initial rupture CT images, the bAVM nidus and major draining vein were segmented, and time-density curves were extracted to compute perfusion parameters including mean transit time (MTT), time to peak (TTP), blood volume (BV), and blood flow (BF). To examine the potential correlation between these parameters and bAVM rupture, logistic regression was utilized to analyze multifactorial data and compare differences between the two groups. The ruptured group demonstrated a bAVM nidus characterized by an increased BF, a shorter TTP and MTT, and a higher peak density. The veins that were draining exhibited a reduced TTP, MTT, and peak density. A nidus TTP of less than 4s was identified by the multifactorial analysis as a critical risk factor for bAVM rupture. The statistical results highlight the noteworthy correlation between nidus TTP and bAVM rupture, presenting an original framework for assessing the risk of rupture.
本研究旨在探讨多相 CT 血管造影（CTA）确定的脑动静脉畸形（bAVM）灌注参数与 bAVM 破裂之间的潜在相关性。基于 bAVM 相关出血的发生，在这项回顾性多中心研究中，我们将 2010 年至 2020 年期间诊断的 480 例 bAVM 患者根据是否发生 bAVM 相关出血分为出血组（n=220）和非出血组（n=260）。在初始破裂 CT 图像上，对 bAVM 病灶和主要引流静脉进行分割，并提取时间密度曲线以计算灌注参数，包括平均通过时间（MTT）、达峰时间（TTP）、血容量（BV）和血流量（BF）。为了检验这些参数与 bAVM 破裂之间的潜在相关性，我们采用逻辑回归分析多因素数据并比较两组之间的差异。破裂组的 bAVM 病灶表现为 BF 增加、TTP 和 MTT 缩短以及峰值密度升高。引流静脉则表现为 TTP、MTT 和峰值密度降低。多因素分析确定病灶 TTP 小于 4s 是 bAVM 破裂的关键危险因素。统计结果突出了病灶 TTP 与 bAVM 破裂之间的显著相关性，为评估破裂风险提供了一个新的框架。
