title: Ultra-high-resolution C-arm flat-detector CT angiography evaluation reveals 3-fold higher association rate for sporadic intracranial cavernous malformations and developmental venous anomalies: a retrospective study in consecutive 58 patients with 60 cavernous malformations.
abstract: OBJECTIVE
  The imaging and surgical literature has confusing association rates for the association between sporadic intracranial cavernous malformations (CMs) and developmental venous anomalies (DVAs). In this study, our purpose was to determine the association rate using ultra-high-resolution C-arm flat-detector CT angiography (FDCTA) and compare it with literature.
  
  
  METHODS
  Fifty-eight patients with 60 sporadic intracranial CMs that underwent an FDCTA study were included in our retrospective study. Re-evaluation of radiological data was performed based on the criteria defined by authors. Isotropic volumetric reconstructions with ultra-high resolution (voxel size of 102 μm3for initial; 67 μm3and 32 μm3for further evaluation) were used for assessment. Sixteen patients underwent surgery for excision of their CMs.
  
  
  RESULTS
  Fifty-one of all patients (87.9 %) were associated with a DVA. Undefined local venous structures (UD-LVSs) were observed in the remaining 7 patients (12.1 %). The strength of interobserver agreement was excellent [kappa(k) coefficient = 0.923].
  
  
  CONCLUSIONS
  Ultra-high-resolution FDCTA evaluation of CMs and DVAs reveals 3-fold higher association rate compared to the literature. FDCTA for patients with sporadic CMs could help identify the associated DVAs that remained undetected or unclear with other imaging modalities, which can be useful in decision-making processes, planning surgery, and during operation.
  
  
  CONCLUSIONS
  • FDCTA evaluation reveals the highest (3-fold) association rate in literature • FDCTA helps detect and define DVAs that remained unclear with other modalities • Ratio of DVAs/UD-LVSs ("variants" in MRI) increases dramatically with FDCTA • FDCTA reveals venous angioarchitecture of CMs in high anatomical detail • FDCTA can be useful in decision-making, planning surgery, and during operation.
authors.affiliation: Department of Radiology, Aksaray State Hospital, Aksaray, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Kocak
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Osman
authors.initials: O
authors.lastname: Kizilkilic
authors.affiliation: Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Buge
authors.initials: B
authors.lastname: Oz
authors.affiliation: Department of Pathology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Dogu Vuralli
authors.initials: DV
authors.lastname: Bakkaloglu
authors.affiliation: Department of Neurosurgery, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Isler
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Naci
authors.initials: N
authors.lastname: Kocer
authors.affiliation: Department of Radiology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey. cislak@istanbul.edu.tr.
authors.forename: Civan
authors.initials: C
authors.lastname: Islak
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002550:Cerebral Veins / Q000002:abnormalities*; D002648:Child; D002675:Child, Preschool; D000072226:Computed Tomography Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis*; D018810:Magnetic Resonance Angiography / Q000379:methods; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies; D055815:Young Adult
keywords: Angiography; Cavernous malformation; Computed tomography; Developmental venous anomaly; Flat detector