Simultaneous Arteriovenous Shunting and Venous Congestion Identification in Dural Arteriovenous Fistulas Using Susceptibility-Weighted Imaging: Initial Experience

Létourneau-Guillon, Laurent; Krings, Timo

doi:10.3174/ajnr.a2777

Cited by 42 publications

(31 citation statements)

References 27 publications

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“…The presence of these efferent pial venous drainage pathways carrying arterialized blood may impact upon the method and approach to treatment of these malformations, 12 and it is therefore important to differentiate them from veins enlarged because of passive venous congestion. These observations on the utility of SWI in differentiating between passive venous congestion and venous dilation from AVS in our series of patients are similar to the observations reported by Letourneau-Guillon and Krings 13 in their recent small series of patients with dural arteriovenous fistulas.…”

Section: Discussionsupporting

confidence: 79%

Susceptibility-Weighted Imaging: A New Tool in the Diagnosis and Evaluation of Abnormalities of the Vein of Galen in Children

Jagadeesan

Cross

Almandoz

et al. 2012

AJNR Am J Neuroradiol

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SUMMARY:We retrospectively identified 9 consecutive children, 3 males and 6 females (age 5.2 Ϯ 6.3 years, range 1 day to 18 years), with known or suspected AVGs who underwent MR imaging, including SWI, at our institution between January 2007 and March 2011. On the SWI sequence, arterialized blood flow was considered to be present in the vein of Galen or its tributaries when these showed abnormal signal hyperintensity from arteriovenous shunting. SWI findings were correlated with findings from DSA studies or findings from time-of-flight or contrast-enhanced MR angiography sequences. SWI was found to accurately differentiate between high-flow and low-flow AVGs and was also useful in characterizing the arterial supply and venous drainage patterns associated with high-flow AVGs.ABBREVIATIONS: AVG ϭabnormality of the vein of Galen; AVS ϭ arteriovenous shunting; VGAD ϭ vein of Galen aneurysmal dilation; VGAM ϭ vein of Galen aneurysmal malformation S WI is an MR imaging technique that combines both phase and magnitude signal to produce high-resolution images of the cerebral venous system. 1 In SWI, veins appear hypointense due to the presence of deoxyhemoglobin and the arteries are hyperintense due to time-of-flight effects and lack of T2* effects. 1,2It has recently been shown that this property of SWI could be used to accurately detect AVS in cerebral vascular malformations by identifying the presence of abnormal hyperintense signal within the veins draining these malformations; this high signal is a result of AVS and arterialized blood flow in these veins.3 SWI studies are of high resolution and do not require intravenous contrast administration, features that can make these studies particularly useful in evaluating the presence of AVS in cerebral vascular malformations occurring in small children. We therefore retrospectively reviewed the utility of SWI in a series of patients with abnormalities of the vein of Galen. When there is AVS associated with such abnormalities, it could be from arteriovenous shunting into a persistent median vein of the prosencephalon (vein of Markowski), otherwise called a VGAM, or from a pial arteriovenous malformation that drains into the vein of Galen, resulting in a VGAD. In this context, we studied if the SWI technique could accurately differentiate between VGAMs and VGADs. When either of these high-flow abnormalities with AVS were identified by the SWI studies, we assessed the ability of these studies to provide information on the angioarchitecture associated with these abnormalities as well as their hemodynamic consequences. Case Series Patient SelectionThe study was approved by our hospital's institutional review board and conducted in compliance with the Health Insurance Portability and Accountability Act. On a retrospective review of a prospectively maintained data base, we found that between January 1, 2007, and February 28, 2010, 9 children (6 females and 3 males, mean age 5.2 Ϯ 6.3 years) underwent MR imaging with SWI at our institution for evaluation of known or suspected AV...

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Section: Discussionsupporting

confidence: 79%

Susceptibility-Weighted Imaging: A New Tool in the Diagnosis and Evaluation of Abnormalities of the Vein of Galen in Children

Jagadeesan

Cross

Almandoz

et al. 2012

AJNR Am J Neuroradiol

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“…Therefore, the combination of other MR imaging methods may help to differentiate this condition. Recent reports have suggested that some advanced MR imaging techniques such as dynamic susceptibility contrast (DSC) and susceptibility-weighted imaging (SWI) are capable of detecting and evaluating cortical venous reflux and venous congestion in patients with DAVF [25][26][27]. Further studies may be necessary to assess the value of the combination of ASL and other advanced MR imaging such as DSC and SWI for the demonstration of cortical venous reflux in DAVF.…”

Section: Discussionmentioning

confidence: 99%

Intracranial Dural Arteriovenous Fistula: Preliminary Report of Arterial Spin Labeling

Noguchi¹,

Kawabe²,

Seto³

2013

OJMI

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Purpose: We report the results of applying arterial spin labeling (ASL) to intracranial dural arteriovenous fistula (DAVF). Methods: Sixteen patients with angiographically confirmed DAVF underwent ASL on a clinical 1.5 T or 3 T MR system. ASL was performed by Q2TIPS (second version of quantitative imaging of perfusion by using a single subtraction MRI pulse sequence with thin-slice TI1 periodic saturation) with echo-planar imaging. Draining veins such as dural venous sinus and cortical veins were evaluated on ASL. Results: ASL clearly depicted draining dural venous sinus in all patients with DAVF Borden type I (6/6, 100%) and type II (4/4, 100%). ASL depicted cortical venous reflux in only one patient with DAVF Borden type II (1/4, 25%). ASL depicted drainage directly into cortical veins in all patients with Borden type III (6/6, 100%). Conclusion: Our preliminary study suggests that ASL can depict draining veins in patients with DAVF.

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“…In this study, only local venous prominence on SWI was considered positive, and whole brain venous prominence was not judged positive. The ability of SWI to distinguish normal venous structures and abnormal congested veins should ideally be evaluated in a larger study including a control group of patients [18]. The final limitation is that hemodynamic loads by the thrombus and collaterals were not directly evaluated at the same time as SWI evaluation.…”

Section: Discussionmentioning

confidence: 99%

Venous Stasis and Cerebrovascular Complications in Cerebral Venous Sinus Thrombosis

et al. 2017

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Background/Aims: The factors related to cerebrovascular complications in cerebral venous sinus thrombosis (CVST) are controversial. We focused on venous stasis and investigated its relationship with cerebrovascular complications in CVST. Methods: CVST patients between June 2013 and October 2016 were enrolled. Relationships between cerebrovascular complications, defined as cerebral venous infarction, intracerebral hemorrhage, or subarachnoid hemorrhage, and cerebrum venous stasis and other clinical information were retrospectively analyzed. Venous stasis was evaluated by the prominence of the veins on susceptibility-weighted imaging (SWI). The cerebrum was divided into 10 regions according to the venous drainage territories, and venous stasis was quantified by adding one point for venous prominence on SWI for each region (CVST SWI score). Results: All 5 cases in the noncomplicated group had a CVST SWI score of 0. The 3 patients with CVST SWI scores higher than 0 had cerebrovascular complications. The CVST SWI scores were higher in the complicated group than in the noncomplicated group (3.0 vs. 0, p = 0.010). Seizures were seen in all patients with complications and in none of the patients without complications (3 vs. 0, p = 0.018). Conclusion: Venous stasis evaluated by SWI can help predict cerebrovascular complications in CVST. A seizure is an important initial symptom that suggests cerebrovascular complications in CVST.

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Simultaneous Arteriovenous Shunting and Venous Congestion Identification in Dural Arteriovenous Fistulas Using Susceptibility-Weighted Imaging: Initial Experience

Cited by 42 publications

References 27 publications

Susceptibility-Weighted Imaging: A New Tool in the Diagnosis and Evaluation of Abnormalities of the Vein of Galen in Children

Susceptibility-Weighted Imaging: A New Tool in the Diagnosis and Evaluation of Abnormalities of the Vein of Galen in Children

Intracranial Dural Arteriovenous Fistula: Preliminary Report of Arterial Spin Labeling

Venous Stasis and Cerebrovascular Complications in Cerebral Venous Sinus Thrombosis

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