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Intranidal Signal Distribution in Post-Contrast Time-of-Flight MRA is Associated with Rupture Risk Factors in Arteriovenous Malformations.
MedLine Citation:
PMID:  22923023     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To evaluate if arteriovenous malformations (AVMs) that are associated with a high rupture risk (HRR) are represented by different intranidal Time-of-Flight (TOF) magnetic resonance angiography intensity distributions compared to those with presumably low rupture risk (LRR). METHODS: Fifty post-contrast TOF datasets of patients with an AVM were analyzed in this study. The patients were classified to the HRR group in case of a deep location, presence of exclusive deep venous drainage, previous hemorrhagic event or a combination thereof. For each TOF dataset, the AVM nidus was semi-automatically delineated and used for histogram extraction. Each histogram was analyzed by calculating the skewness, kurtosis, mean and median intensity and full-width-half-maximum. Statistical analysis was performed using parameter-wise two-sided t-tests of the parameters between the two groups. RESULTS: Based on morphological analysis, 21 patients were classified to the HRR and 29 patients to the LRR group. Statistical analysis revealed that TOF intensity distributions of HRR AVMs exhibit a significant higher skewness (p = 0.0005) parameter compared to LRR AVMs. Contrary to these findings, no significant differences were found for the other parameters evaluated. CONCLUSION: Intranidal flow heterogeneity, for example, caused by turbulent flow conditions, may play an important role for risk of a hemorrhage. An analysis of post-contrast TOF intensities within the nidus of an AVM may offer simple and valuable information for clinical risk estimation of AVMs and needs to be tested prospectively.
Authors:
N D Forkert; J Fiehler; M Schönfeld; J Sedlacik; J Regelsberger; H Handels; T Illies
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-8-26
Journal Detail:
Title:  Clinical neuroradiology     Volume:  -     ISSN:  1869-1447     ISO Abbreviation:  Clin Neuroradiol     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-8-27     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101526693     Medline TA:  Clin Neuroradiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
Department of Computational Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany, n.forkert@uke.uni-hamburg.de.
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