机构:[1]Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada[2]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China重点科室医技科室研究所放射科放射科北京市神经外科研究所首都医科大学附属天坛医院[3]Beijing Engineering Research Center for Interventional Neuroradiology, Beijing, China[4]Department of Neurosurgery, Changhai Hospital, Second Military Medical University, Shanghai, China[5]Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada[6]Krembil Neuroscience Center, University Health Network, Toronto, Ontario, Canada
OBJECTIVE The goal of this study was to describe changes in the angioarchitecture of brain arteriovenous malformations (bAVMs) between acute and delayed cerebral digital subtraction angiography (DSA) obtained after hemorrhage, and to examine bAVM characteristics predicting change. METHODS This is a retrospective study of a prospective institutional bAVM database. The authors included all patients with ruptured bAVMs who had DSA in both acute and delayed phases, with no interval treatment of their bAVM, between January 2000 and April 2017. The authors evaluated the existence or absence of angioarchitectural changes. Demographic data, radiological characteristics of hemorrhages, and angioarchitectural features of the bAVMs of the two patients' groups were analyzed. Univariate and multivariate logistic analyses were performed to identify predictors of angioarchitectural change. RESULTS A total of 42 patients were included in the series. Seventeen (40.5%) patients had angioarchitectural changes including bAVM only visible on the delayed DSA study (n = 8), spontaneous thrombosis of the AVM (n = 3), or alteration of the size or the opacification of the nidus (n = 6). The factors associated with angioarchitectural changes were a small nidus (3.8 +/- 7.9 ml vs 6.1 +/- 9.5 ml, p = 0.046), a superficial location (94.1% vs 5.9%, p = 0.016), and a single superficial draining vein (58.8% vs 24.0%, p = 0.029). CONCLUSIONS Angioarchitectural changes can be seen in 40% of ruptured bAVMs between the acute- and delayed-phase DSA. A small nidus, a superficial location, and a single superficial draining vein were statistically associated with the occurrence of angioarchitectural changes. These changes included either enlargement or spontaneous occlusion of the bAVM, as well as subsequent diagnosis of a bAVM following an initial negative DSA study.
基金:
Beijing Municipal Health Bureau: Special Research Project of Capital Health Development, China [2016-1-1075]; Assistance Publique des Hopitaux de Paris, France: Bourse de mobilite APHP
第一作者机构:[1]Division of Neuroradiology, Department of Medical Imaging, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada[2]Department of Interventional Neuroradiology, Beijing Neurosurgical Institute and Beijing Tiantan Hospital, Capital Medical University, Beijing, China
通讯作者:
通讯机构:[5]Division of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada[6]Krembil Neuroscience Center, University Health Network, Toronto, Ontario, Canada[*1]Toronto Western Hospital, University Health Network and University of Toronto, Toronto, ON, Canada
推荐引用方式(GB/T 7714):
Hengwei Jin,Stephanie Lenck,Timo Krings,et al.Interval angioarchitectural evolution of brain arteriovenous malformations following rupture[J].JOURNAL OF NEUROSURGERY.2019,131(1):96-103.doi:10.3171/2018.2.JNS18128.
APA:
Hengwei Jin,Stephanie Lenck,Timo Krings,Ronit Agid,Yibin Fang...&Ivan Radovanovic.(2019).Interval angioarchitectural evolution of brain arteriovenous malformations following rupture.JOURNAL OF NEUROSURGERY,131,(1)
MLA:
Hengwei Jin,et al."Interval angioarchitectural evolution of brain arteriovenous malformations following rupture".JOURNAL OF NEUROSURGERY 131..1(2019):96-103