title: The angioarchitectural factors of the cerebral developmental venous anomaly; can they be the causes of concurrent sporadic cavernous malformation?
abstract: BACKGROUND
  The aim of this paper was to evaluate the angioarchitectural factors that can induce concurrent cavernous malformation (CM) in the territory of developmental venous anomaly (DVA).
  
  
  METHODS
  From January 2006 to December 2007, 21 patients with 23 CMs in the territory of DVA were retrospectively analyzed (M; F = 12; 9, mean age = 53.3). Gadovist®-enhanced three-dimensional spoiled gradient-echo images on a 3 T magnetic resonance (MR) scanner were used. We investigated the presence of angioarchitectural factors: factor 1, the angulated course of curved medullary or draining vein in the distal portion of CM; factor 2, narrowing of distal draining vein; factor 3, severe medullary venous tortuosity. These were also analyzed for control group of 23 subjects (M; F = 11; 12, mean age = 46).
  
  
  RESULTS
  Factor 1 was demonstrated in 22 cases (97%) and the CM occurred in a position of 90° or less of an abrupt angulated medullary or draining vein in 15 cases (65%) of the study group. Factor 2 was found in 13 cases (57%) with the diameter reduction of 50% or more in five cases. The mean ratio of diameter reduction was 0.53. Factor 3 was found in 17 cases (74%). Analyzing the independent factors, the p values for factors 1 and 3 were <.05, i.e., statistically significant. If combination of more than two factors was present, the p values for all the combinations were <0.05, i.e., statistically significant.
  
  
  CONCLUSIONS
  Anatomical angioarchitectural factors might be the key factors in causing concurrent sporadic CM within the territory of DVA by causing disturbance of blood flow.
authors.affiliation: Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eunjuro, Gangnam-gu, Seoul, South Korea, 135-270.
authors.forename: Yoo Jin
authors.initials: YJ
authors.lastname: Hong
authors.forename: Tae-Sub
authors.initials: TS
authors.lastname: Chung
authors.forename: Sang Hyun
authors.initials: SH
authors.lastname: Suh
authors.forename: Chul Hwan
authors.initials: CH
authors.lastname: Park
authors.forename: Geetanjali
authors.initials: G
authors.lastname: Tomar
authors.forename: Kwon Duk
authors.initials: KD
authors.lastname: Seo
authors.forename: Keung Sik
authors.initials: KS
authors.lastname: Kim
authors.forename: In Kook
authors.initials: IK
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D001932:Brain Neoplasms / Q000150:complications* / Q000473:pathology*; D002550:Cerebral Veins / Q000002:abnormalities* / Q000473:pathology*; D005260:Female; D020786:Hemangioma, Cavernous, Central Nervous System / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity