The Associated Venous Anomalies Variant and Adjacent Brain Function on Iron Sensitive Image Indicate Surgical Risk of Cavernous Malformation.
The Associated Venous Anomalies Variant and Adjacent Brain Function on Iron Sensitive Image Indicate Surgical Risk of Cavernous Malformation.
复制标题
铁敏感图像上相关的静脉异常变异和邻近脑功能表明海绵状血管畸形的手术风险
DOI：
10.2176/nmc.oa.2015-0057
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发表时间：
2016
影响因子：
1.9
通讯作者：
Zhao YL
中科院分区：
文献类型：
--
作者：
Ma L;Chen XL;Ma J;Zhao YL
海绵体畸形（CMs）与静脉异常（VAs）现在被描述的频率越来越高。在CM的外科治疗中，相关VAs的评估被忽视了。回顾性分析伴有VAs的CMs的临床资料，探讨T2*梯度回声(GRE)/敏感性加权成像（SWI）在手术风险评估中的价值。在2008年至2013年间确定了26例与VAs相关的症状性CMs患者。回顾了人口统计学、临床和放射学数据，并使用改进的Rankin量表（mRS）评估功能结果。与增强成像相比，T2*GRE/SWI可以更准确地评估输精管边界和输精管附近的引流（6例对2例输精管位于雄辩区）。VAs邻近雄辩脑区患者预后差于非雄辩脑区患者（P = 0.005），而CMs邻近雄辩脑区患者预后差不相关（P = 0.15）。与II型变异相比，I型和III型变异VAs也与不良预后显著相关（P = 0.002）。仔细评估VAs变异类型以及VAs与脑功能紊乱的关系有助于VAs相关CMs的管理。我们推荐对CMs患者进行T2*GRE/SWI评估相关VAs。T2*GRE/SWI评价VA引流邻近区对设计治疗策略和风险分层更有帮助。
The cavernous malformations (CMs) associated with venous anomalies (VAs) are now being described with increasing frequency. Assessment of the associated VAs is overlooked in surgical management of the CM. The clinical profiles of CMs with VAs were reviewed to investigate the value of T2*gradient echo (GRE)/susceptibility weighted imaging (SWI) in surgical risk evaluation. Twenty-six patients with symptomatic CMs associated with VAs between 2008 and 2013 were identified. Demographic, clinical, and radiological data were reviewed and functional outcomes were assessed using the modified Rankin Scale (mRS). The T2*GRE/SWI could allow more accurate evaluation of the boundary and drainage vicinity of VAs than contrast-enhanced images (6 vs. 2 patients with VAs on the eloquent region). Patients with VAs adjacent to eloquent brain showed poorer outcomes than those who had VAs in non-eloquent areas (P = 0.005), while the CMs adjacent to eloquent brain did not correlated with poor outcomes (P = 0.15). Type I and III variants of VAs were also significantly associated with poor outcomes, compared with type II variant (P = 0.002). Careful evaluation of VAs variant type and the association between VAs and eloquent brain is helpful for the management of CMs associated with VAs. We recommend T2*GRE/SWI in patients with CMs to assess the associated VAs. The evaluation of VA drainage vicinity on T2*GRE/SWI would be more useful for designing treatment strategies and risk stratification.