Investig Magn Reson Imaging.  2015 Sep;19(3):146-152. 10.13104/imri.2015.19.3.146.

Associated Brain Parenchymal Abnormalities in Developmental Venous Anomalies: Evaluation with Susceptibility-weighted MR Imaging

• Ryu HG
• Choi DS
• Cho SB
• Shin HS
• Choi HC
• Jeong B
• Seo H
• Cho JM

• KMID: 2175605
• DOI: http://doi.org/10.13104/imri.2015.19.3.146

Abstract

PURPOSE
The purpose of this study was to evaluate the associated brain parenchymal abnormalities of developmental venous anomalies (DVA) with susceptibility-weighted image (SWI).
MATERIALS AND METHODS
Between January 2012 and June 2013, 2356 patients underwent brain MR examinations with contrast enhancement. We retrospectively reviewed their MR examinations and data were collected as per the following criteria: incidence, locations, and associated parenchymal signal abnormalities of DVAs on T2-weighted image, fluid-attenuated inversion recovery (FLAIR), and SWI. Contrast enhanced T1-weighted image was used to diagnose DVA.
RESULTS
Of the 2356 patients examined, 57 DVAs were detected in 57 patients (2.4%); 47 (82.4%) were in either lobe of the supratentorial brain, 9 (15.7%) were in the cerebellum, and 1 (1.7%) was in the pons. Of the 57 DVAs identified, 20 (35.1%) had associated parenchymal abnormalities in the drainage area. Among the 20 DVAs which had associated parenchymal abnormalities, 13 showed hemorrhagic foci on SWI, and 7 demonstrated only increased parenchymal signal abnormalities on T2-weighted and FLAIR images. In 5 of the 13 patients (38.5%) who had hemorrhagic foci, the hemorrhagic lesions were demonstrated only on SWI.
CONCLUSION
The overall incidence of DVAs was 2.4%. Parenchymal abnormalities were associated with DVAs in 35.1% of the cases. On SWI, hemorrhage was detected in 22.8% of DVAs. Thus, we conclude that SWI might give a potential for understanding of the pathophysiology of parenchymal abnormalities in DVAs.

Keyword

Cerebral developmental venous anomaly; Hemorrhage; MR; Susceptibility-weighted imaging (SWI)

MeSH Terms

Brain*
Cerebellum
Drainage
Hemorrhage
Humans
Incidence
Magnetic Resonance Imaging*
Pons
Retrospective Studies

Figure

• 

  Fig. 1 A 55-year-old female with a DVA. Enhanced T1-weighted image (a) and SWI (b) show a DVA in the left parietal lobe (short arrows). T2-weighted (c) and FLAIR (d) images reveal parenchymal signal abnormalities in and around the DVA (long arrows).

• 

  Fig. 2 A 36-year-old female with a DVA. Enhanced T1-weighted (a), SWI (b), T2-weighted (c) and FLAIR (d) images show a DVA (long arrows) and an associated hemorrhagic lesion (short arrows) in the right frontal lobe and corpus callosum. Both the DVA and hemorrhagic lesion are more conspicuously demonstrated on SWI than on T2-weighted and FLAIR images.

• 

  Fig. 3 A 59-year-old female with a DVA. Enhanced T1-weighted image (a) and SWI (b) show a DVA in the right frontoparietal lobe (long arrows). There is also a focal hemorrhagic lesion on SWI (short arrows). T2-weighted (c) and FLAIR (d) images demonstrate hyperintense signal abnormalities in the drainage territory of the DVA (long arrows). The hemorrhagic lesion is seen as a focal cystic lesion (short arrows).

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