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Dynamic susceptibility contrast-enhanced perfusion-weighted MR imaging and diffusion-weighted MR imaging are noninvasive promising methods that are used for differentiation of malignant from benign parotid tumors and for characterization of some benign parotid tumors.

Aim To classify venous malformations based on contrast-enhanced MR angiography that may serve as a basis for treatment plan. Patients and methods A retrospective analysis was performed in 58 patients with venous malformations who underwent contrast-enhanced MR angiography. Venous malformations were classified according to their venous drainage into: type I, isolated malformation without peripheral drainage; type II, malformation that drains into normal veins; type III, malformation that drains into dilated veins; and type IV, malformation that represents dysplastic venous ectasia. Image analysis was done by two reviewers. Intra and inter-observer agreement of both reviewers and intra-class correlation was done. Results The intra-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for the first reviewer ( k = 0.83, 95% CI = 0.724-0.951, P = 0.001) and substantial for the second reviewer ( K = 0.79, 95% CI = 0.656-0.931, P = 0.001). The inter-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for both reviewers at the first time ( K = 0.96, 95% CI = 0.933-1.000, P = 0.001) and second time ( k = 0.81, 95% CI = 0.678-0.942, P = 0.001). There was high intra-class correlation of both reviewers for single measure ( ICC = 0.85, 95% CI = 0.776-0.918, P = 0.001) and for average measures ( ICC = 0.96, 95% CI = 0.933-0.978, P = 0.001). Conclusion Contrast-enhanced MR angiography classification of venous malformations may be a useful, simple and reliable tool to accurately classify venous malformation and this topographic classification helps for better management strategy.

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