Hemodynamic Analysis of Cerebral AVMs with 3D Phase-Contrast MR Imaging
Hemodynamic Analysis of Cerebral AVMs with 3D Phase-Contrast MR Imaging
复制标题
DOI：
10.3174/ajnr.a7314
复制
发表时间：
2021-10
影响因子：
3.5
通讯作者：
Y. Takeda;T. Kin;T. Sekine;H. Hasegawa;Y. Suzuki;H. Uchikawa;T. Koike;S. Kiyofuji;Y. Shinya;M. Kawashima;N. Saito
中科院分区：
文献类型：
--
作者：
Y. Takeda;T. Kin;T. Sekine;H. Hasegawa;Y. Suzuki;H. Uchikawa;T. Koike;S. Kiyofuji;Y. Shinya;M. Kawashima;N. Saito
背景和目的：脑AVM相关的血流动力学对其临床表现有显著影响。本研究旨在使用双速度编码的3D相位对比MR成像评价AVM的血流动力学特征。材料和方法：本研究纳入了32例幕上AVM患者，这些患者既往未接受过任何治疗，并接受了3D相位对比MR成像。测量病灶直径和体积，以进行AVM分类（小型、中型或大型）。测量的血流参数包括表观AVM流入量、AVM流入指数、表观AVM流出量、AVM流出指数和表观AVM流入流出比。计算病灶体积和每个流量之间的相关系数。比较了小AVM与其他AVM以及非出血性AVM与出血性AVM之间的血流参数。结果：患者分为出血组（n = 8）和非出血组（n = 24）。病灶体积与明显AVM流入和流出之间的相关系数为0.83。小AVM的表观AVM流入和流出明显小于中型AVM（两组均P <0.001）。出血性AVM的表观AVM流入流出比明显大于非出血性AVM（P = 0.02）。结论：表观AVM流入流出比是非出血性和出血性AVM之间唯一不同的显著参数，表明引流系统不良可能会增加AVM压力，可能导致脑出血。
BACKGROUND AND PURPOSE: The hemodynamics associated with cerebral AVMs have a significant impact on their clinical presentation. This study aimed to evaluate the hemodynamic features of AVMs using 3D phase-contrast MR imaging with dual velocity-encodings. MATERIALS AND METHODS: Thirty-two patients with supratentorial AVMs who had not received any previous treatment and had undergone 3D phase-contrast MR imaging were included in this study. The nidus diameter and volume were measured for classification of AVMs (small, medium, or large). Flow parameters measured included apparent AVM inflow, AVM inflow index, apparent AVM outflow, AVM outflow index, and the apparent AVM inflow-to-outflow ratio. Correlation coefficients between the nidus volume and each flow were calculated. The flow parameters between small and other AVMs as well as between nonhemorrhagic and hemorrhagic AVMs were compared. RESULTS: Patients were divided into hemorrhagic (n = 8) and nonhemorrhagic (n = 24) groups. The correlation coefficient between the nidus volume and the apparent AVM inflow and outflow was .83. The apparent AVM inflow and outflow in small AVMs were significantly smaller than in medium AVMs (P < .001 for both groups). The apparent AVM inflow-to-outflow ratio was significantly larger in the hemorrhagic AVMs than in the nonhemorrhagic AVMs (P = .02). CONCLUSIONS: The apparent AVM inflow-to-outflow ratio was the only significant parameter that differed between nonhemorrhagic and hemorrhagic AVMs, suggesting that a poor drainage system may increase AVM pressure, potentially causing cerebral hemorrhage.