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Evaluation of 4D vascular flow and tissue perfusion in cerebral arteriovenous malformations: influence of Spetzler-Martin grade, clinical presentation, and AVM risk factors.
Wu, C; Ansari, S A; Honarmand, A R; Vakil, P; Hurley, M C; Bendok, B R; Carr, J; Carroll, T J; Markl, M.
Afiliação
  • Wu C; From the Department of Biomedical Engineering (C.W., T.J.C., M.M.), McCormick School of Engineering, Northwestern University, Evanston, Illinois Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.) canwu2016@u.northwestern.edu.
  • Ansari SA; Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.) Neurological Surgery (S.A.A., M.C.H., B.R.B.) Neurology (S.A.A.).
  • Honarmand AR; Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.).
  • Vakil P; Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.).
  • Hurley MC; Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.) Neurological Surgery (S.A.A., M.C.H., B.R.B.).
  • Bendok BR; Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.) Neurological Surgery (S.A.A., M.C.H., B.R.B.) Otolaryngology (B.R.B.), Feinberg School of Medicine, Northwestern University, Chicago, Illinois.
  • Carr J; Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.).
  • Carroll TJ; From the Department of Biomedical Engineering (C.W., T.J.C., M.M.), McCormick School of Engineering, Northwestern University, Evanston, Illinois Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.).
  • Markl M; From the Department of Biomedical Engineering (C.W., T.J.C., M.M.), McCormick School of Engineering, Northwestern University, Evanston, Illinois Departments of Radiology (C.W., S.A.A., A.R.H., P.V., M.C.H., B.R.B., J.C., T.J.C., M.M.).
AJNR Am J Neuroradiol ; 36(6): 1142-9, 2015 Jun.
Article em En | MEDLINE | ID: mdl-25721076
ABSTRACT
BACKGROUND AND

PURPOSE:

The role of intracranial hemodynamics in the pathophysiology and risk stratification of brain AVMs remains poorly understood. The purpose of this study was to assess the influence of Spetzler-Martin grade, clinical history, and risk factors on vascular flow and tissue perfusion in cerebral AVMs. MATERIALS AND

METHODS:

4D flow and perfusion MR imaging was performed in 17 patients with AVMs. Peak velocity and blood flow were quantified in AVM feeding and contralateral arteries, draining veins, and the straight sinus. Regional perfusion ratios (CBF, CBV, and MTT) were calculated between affected and nonaffected hemispheres.

RESULTS:

Regarding flow parameters, high-grade AVMs (Spetzler-Martin grade of >2) demonstrated significantly increased peak velocity and blood flow in the major feeding arteries (P < .001 and P = .004) and straight sinus (P = .003 and P = .012) and increased venous draining flow (P = .001). The Spetzler-Martin grade significantly correlated with cumulative feeding artery flow (r = 0.85, P < .001) and draining vein flow (r = 0.80, P < .001). Regarding perfusion parameters, perinidal CBF and CBV ratios were significantly lower (P < .001) compared with the remote ratios and correlated negatively with cumulative feeding artery flow (r = -0.60, P = .014 and r = -0.55, P = .026) and draining vein flow (r = -0.60, P = .013 and r = -0.56, P = .025). Multiple regression analysis revealed no significant association of AVM flow or perfusion parameters with clinical presentation (rupture and seizure history) and AVM risk factors.

CONCLUSIONS:

Macrovascular flow was significantly associated with increasing Spetzler-Martin grade and correlated with perinidal microvascular perfusion in cerebral AVMs. Future longitudinal studies are needed to evaluate the potential of comprehensive cerebral flow and perfusion MR imaging for AVM risk stratification.
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Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Velocidade do Fluxo Sanguíneo / Angiografia Cerebral / Interpretação de Imagem Assistida por Computador / Angiografia Digital / Malformações Arteriovenosas Intracranianas / Circulação Cerebrovascular / Angiografia por Ressonância Magnética / Imageamento Tridimensional Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: AJNR Am J Neuroradiol Ano de publicação: 2015 Tipo de documento: Article
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Bases de dados: MEDLINE Assunto principal: Velocidade do Fluxo Sanguíneo / Angiografia Cerebral / Interpretação de Imagem Assistida por Computador / Angiografia Digital / Malformações Arteriovenosas Intracranianas / Circulação Cerebrovascular / Angiografia por Ressonância Magnética / Imageamento Tridimensional Tipo de estudo: Diagnostic_studies / Etiology_studies / Observational_studies / Risk_factors_studies Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: AJNR Am J Neuroradiol Ano de publicação: 2015 Tipo de documento: Article