Developmental venous anomalies: appearance on whole-brain CT digital subtraction angiography and CT perfusion.
BACKGROUND
Developmental venous anomalies (DVA) consist of dilated intramedullary veins that converge into a large collecting vein. The appearance of these anomalies was evaluated on whole-brain computed tomography (CT) digital subtraction angiography (DSA) and CT perfusion (CTP) studies.


METHODS
CT data sets of ten anonymized patients were retrospectively analyzed. Five patients had evidence of DVA and five age- and sex-matched controls were without known neurovascular abnormalities. CT angiograms, CT arterial-venous views, 4-D CT DSA and CTP maps were acquired on a dynamic volume imaging protocol on a 320-detector row CT scanner. Whole-brain CTP parameters were evaluated for cerebral blood flow (CBF), cerebral blood volume (CBV), time to peak (TTP), mean transit time (MTT), and delay. DSA was utilized to visualize DVA anatomy. Radiation dose was recorded from the scanner console.


RESULTS
Increased CTP values were present in the DVA relative to the unaffected contralateral hemisphere of 48%, 32%, and 26%; and for the control group with matched hemispheric comparisons of 2%, -10%, and 9% for CBF, CBV, and MTT, respectively. Average effective radiation dose was 4.4 mSv.


CONCLUSIONS
Whole-brain DSA and CTP imaging can demonstrate a characteristic appearance of altered DVA hemodynamic parameters and capture the anomalies in superior cortices of the cerebrum and the cerebellum. Future research may identify the rare subsets of patients at increased risk of adverse outcomes secondary to the altered hemodynamics to facilitate tailored imaging surveillance and application of appropriate preventive therapeutic measures.
Hanson
Eric H
EH
Advanced Medical Imaging and Genetics (Amigenics), 5495 South Rainbow Boulevard, Suite 201, Las Vegas, NV 89118, USA. eric.hanson@amigenics.com
Roach
Cayce J
CJ
Ringdahl
Erik N
EN
Wynn
Brad L
BL
DeChancie
Sean M
SM
Mann
Nathan D
ND
Diamond
Alan S
AS
Orrison
William W
WW
D000328:Adult; D015901:Angiography, Digital Subtraction; D001810:Blood Volume; D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging*; D016022:Case-Control Studies; D002533:Cerebral Angiography; D002550:Cerebral Veins / Q000002:abnormalities / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010477:Perfusion; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed