A preliminary study of angiographic classification and its correlation to treatment of central arteriovenous malformation in the jaw.
OBJECTIVE
To elaborate on the classification of central arteriovenous malformations (AVMs) in the jaw based on angioarchitecture and to evaluate the correlation of this classification with treatment options.


METHODS
X-ray films and digital subtraction angiograms (DSA) of 25 cases with AVMs in the jaw were retrospectively reviewed to evaluate the appearance of bone resorption, feeding arteries, nidus of the malformations, and draining veins. Based on the findings a classification of angioarchitecture was recommended. Furthermore, the treatment results of these cases were reviewed to assess the correlation of this classification system with treatment options.


RESULTS
The angiographic pictures of 25 cases with central AVMs could be divided into 5 types: Type I (n = 5) had diffused microarteriovenous fistulas (AVFs); type II (n = 8) had 1 large venous pouch with all the feeding arteries draining into it; type III (n = 7) had a large venous pouch as well as diffused microAVFs (I+II); type IV (n = 2) had multiple venous pouches; and type V (n = 3) had multiple venous pouches and diffused microAVFs (I + IV). The angioarchitecture corresponded well to the x-ray appearance in all cases except 1 (96%). With respect to the treatment outcomes, type II, III, and IV AVMs gained clinical cure in 100% of the cases, whereas type I and type V AVMs obtained clinical cure only in 60% and 33.3% of the cases, respectively.


CONCLUSIONS
Central AVMs in the jaw contained variant patterns of angioarchitecture and could be divided into 5 types. This angiographic classification was helpful for decision making about appropriate therapy.
Liu
Deng-gao
DG
Department of Oral Radiology, Peking University School of Stomatology, Beijing, China. kqliuyanting@bjmu.edu.cn
Ma
Xu-chen
XC
Zhao
Fu-yun
FY
Zhang
Jian-guo
JG
D000293:Adolescent; D000328:Adult; D000792:Angiography; D001165:Arteriovenous Malformations / Q000145:classification / Q000000981:diagnostic imaging / Q000628:therapy; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002648:Child; D003475:Curettage; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D007568:Jaw / Q000098:blood supply*; D008297:Male; D008438:Maxillary Artery / Q000000981:diagnostic imaging; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed