title: Topological Analysis for Arteriovenous Malformations via Computed Tomography Angiography: Part 2: Practical Application.
abstract: BACKGROUND
  In a previous study, the authors outlined a technique for calculating the number of abnormal vascular loop structures described in 3-dimensional computed tomography angiography. To be developed into a quantitative evaluation method for soft-tissue arteriovenous malformations (AVMs), the concept needs assessment of validity.
  
  
  METHODS
  Computed tomography angiography results of 19 soft-tissue AVMs and 18 control abdominal vessels are utilized. Enhanced vascular lumen regions over 120 HU were extracted by a region growing method and skeletonized into wire frame graph models. The number of vascular loop structures in graphs is calculated as 1 - [Number of nodes] + [Number of edges], and results are compared between AVM/control groups, pre-/postprogression, and pre-/posttreatment.
  
  
  RESULTS
  Average vascular lumen capacity of AVMs was 57.5 ml/lesion, and average number of vascular loops was 548 loops/lesion. Loop density of AVMs (weighted average, 9.5 loops/ml) exhibited statistically significant (P < 0.001) greater value than normal abdominal blood vessels (weighted average, 1.3 loops/ml). In all 4 cases without treatment, number of loops and loop density both increased. Particularly, number of loops increased greatly by 2 times or more in 3 cases. In all 7 cases with treatment, number of loops and vascular lumen capacity significantly (P = 0.0156) decreased. Particularly, number of loops showed clearer decrease in cases with entire lesion treatment than partial treatment.
  
  
  CONCLUSIONS
  Total number of described vascular loop structures and their density or volume well reflected the existence, progression, and remission of soft-tissue AVMs. Topological analysis can be expected to be developed into a quantitative evaluation for AVMs.
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Yuki
authors.initials: Y
authors.lastname: Hata
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Keigo
authors.initials: K
authors.lastname: Osuga
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uehara
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Yano
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Kikuchi
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Tomita
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Matsuda
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Tateki
authors.initials: T
authors.lastname: Kubo
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Fujiwara
authors.affiliation: Departments of Plastic Surgery, Diagnostic and Interventional Radiology, and Pediatric Surgery, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Ko
authors.initials: K
authors.lastname: Hosokawa