Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

ACC 2024 Congress

Catch up on all the top stories and latest evidence in cardiology research with our ACC 2024 Congress hub page.
ADVANCED SEARCH
Log in
Top
European Radiology
Published in: European Radiology 6/2017

01-06-2017 | Neuro

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

Authors: Burak Kocak, Osman Kizilkilic, Buge Oz, Dogu Vuralli Bakkaloglu, Cihan Isler, Naci Kocer, Civan Islak

Published in: European Radiology | Issue 6/2017

Login to get access

Abstract

Objectives

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 μm3 for initial; 67 μm3 and 32 μm3 for 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.

Key Points

• 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
Literature
1.
Batra S, Lin D, Recinos PF et al (2009) Cavernous malformations: natural history, diagnosis and treatment. Nat Rev Neurol 5:659–670CrossRefPubMed
2.
3.
Zabramski JM, Wascher TM, Spetzler RF et al (1994) The natural history of familial cavernous malformations: results of an ongoing study. J Neurosurg 80:422–432CrossRefPubMed
4.
Riant F, Bergametti F, Ayrignac X et al (2010) Recent insights into cerebral cavernous malformations: the molecular genetics of CCM. FEBS J 277:1070–1075CrossRefPubMed
5.
Rigamonti D, Hadley MN, Drayer BP et al (1988) Cerebral cavernous malformations. Incidence and familial occurrence. N Engl J Med 319:343–347CrossRefPubMed
6.
7.
Larson JJ, Ball WS, Bove KE et al (1998) Formation of intracerebral cavernous malformations after radiation treatment for central nervous system neoplasia in children. J Neurosurg 88:51–56CrossRefPubMed
8.
Campeau NG, Lane JI (2005) De novo development of a lesion with the appearance of a cavernous malformation adjacent to an existing developmental venous anomaly. AJNR Am J Neuroradiol 26:156–159PubMed
9.
Perrini P, Lanzino G (2006) The association of venous developmental anomalies and cavernous malformations: pathophysiological, diagnostic, and surgical considerations. Neurosurg Focus 21, e5CrossRefPubMed
10.
Petersen TA, Morrison LA, Schrader RM, Hart BL (2010) Familial versus sporadic cavernous malformations: differences in developmental venous anomaly association and lesion phenotype. AJNR Am J Neuroradiol 31:377–382CrossRefPubMed
11.
Awad IA, Robinson JR, Mohanty S, Estes ML (1993) Mixed vascular malformations of the brain: clinical and pathogenetic considerations. Neurosurgery 33:179–188, discussion 188
12.
Lasjaunias P, Burrows P, Planet C (1986) Developmental venous anomalies (DVA): the so-called venous angioma. Neurosurg Rev 9:233–242CrossRefPubMed
13.
Hong YJ, Chung T-S, Suh SH et al (2010) The angioarchitectural factors of the cerebral developmental venous anomaly; can they be the causes of concurrent sporadic cavernous malformation? Neuroradiology 52:883–891CrossRefPubMed
14.
Rigamonti D, Spetzler RF, Medina M et al (1990) Cerebral venous malformations. J Neurosurg 73:560–564CrossRefPubMed
15.
Robinson JR, Awad IA, Masaryk TJ, Estes ML (1993) Pathological heterogeneity of angiographically occult vascular malformations of the brain. Neurosurgery 33:547–554, discussion 554–5
16.
Clatterbuck RE, Elmací I, Rigamonti D (2001) The juxtaposition of a capillary telangiectasia, cavernous malformation, and developmental venous anomaly in the brainstem of a single patient: case report. Neurosurgery 49:1246–1250PubMed
17.
Abdulrauf SI, Kaynar MY, Awad IA (1999) A comparison of the clinical profile of cavernous malformations with and without associated venous malformations. Neurosurgery 44:41–46, discussion 46–7
18.
Abe M, Asfora WT, DeSalles AA, Kjellberg RN (1990) Cerebellar venous angioma associated with angiographically occult brain stem vascular malformation. Report of two cases. Surg Neurol 33:400–403CrossRefPubMed
19.
Diamond C, Torvik A, Amundsen P (1976) Angiographic diagnosis of teleangiectases with cavernous angioma of the posterior fossa. Report of two cases. Acta Radiol Diagn 17:281–288CrossRef
20.
McCormick PW, Spetzler RF, Johnson PC, Drayer BP (1993) Cerebellar hemorrhage associated with capillary telangiectasia and venous angioma: a case report. Surg Neurol 39:451–457CrossRefPubMed
21.
Moriarity J, Wetzel M, Clatterbuck R et al (1999) The natural history of cavernous malformations: a prospective study of 68 patients. Neurosurgery 44:1166–1171, discussion 1172–3
22.
Rigamonti D, Spetzler RF (1988) The association of venous and cavernous malformations. Report of four cases and discussion of the pathophysiological, diagnostic, and therapeutic implications. Acta Neurochir (Wien) 92:100–105CrossRef
23.
Bertalanffy H, Benes L, Miyazawa T et al (2002) Cerebral cavernomas in the adult. Review of the literature and analysis of 72 surgically treated patients. Neurosurg Rev 25:1–53, discussion 54–5
24.
Kamezawa T, Hamada J-I, Niiro M et al (2005) Clinical implications of associated venous drainage in patients with cavernous malformation. J Neurosurg 102:24–28CrossRefPubMed
25.
Porter RW, Detwiler PW, Spetzler RF et al (1999) Cavernous malformations of the brainstem: experience with 100 patients. J Neurosurg 90:50–58CrossRefPubMed
26.
Wurm G, Schnizer M, Fellner FA (2007) Cerebral cavernous malformations associated with venous anomalies: surgical considerations. Neurosurgery 61:390–404, discussion 404–6
27.
28.
Frischer JM, Göd S, Gruber A et al (2012) Susceptibility-weighted imaging at 7 T: improved diagnosis of cerebral cavernous malformations and associated developmental venous anomalies. NeuroImage Clin 1:116–120CrossRefPubMedPubMedCentral
29.
Dammann P, Wrede KH, Maderwald S et al (2013) The venous angioarchitecture of sporadic cerebral cavernous malformations: a susceptibility weighted imaging study at 7 T MRI. J Neurol Neurosurg Psychiatry 84:194–200CrossRefPubMed
30.
Orth RC, Wallace MJ, Kuo MD (2008) C-arm cone-beam CT: general principles and technical considerations for use in interventional radiology. J Vasc Interv Radiol 19:814–820CrossRefPubMed
31.
Gupta R, Grasruck M, Suess C et al (2006) Ultra-high resolution flat-panel volume CT: fundamental principles, design architecture, and system characterization. Eur Radiol 16:1191–1205CrossRefPubMed
32.
33.
Frischer JM, Pipp I, Stavrou I et al (2008) Cerebral cavernous malformations: congruency of histopathological features with the current clinical definition. J Neurol Neurosurg Psychiatry 79:783–788CrossRefPubMed
34.
Russel D, Rubinstein L (1959) Tumors and harmatomas of the blood vessels. In: DS R, LJ R (eds) Pathol tumors Nerv Syst. Arnold, London, p 72–92
35.
Zabramski JM, Henn JS, Coons S (1999) Pathology of cerebral vascular malformations. Neurosurg Clin N Am 10:395–410PubMed
36.
Bruner J, Tien R, McLendon R (1986) Tumors of vascular origin. In: DD B, RE M, JM B (eds) Russel Rubinstein’s Pathol tumors thenervous Syst. Arnold, London, p 239–293
37.
Jellinger K (1986) Vascular malformations of the central nervous system: a morphological overview. Neurosurg Rev 9:177–216CrossRefPubMed
38.
Johnson P, Wascher T, Golfinos J (1993) Definition and pathologic features. In: Awad I, Barrow D (eds) Cavernous malformations. AANS, Park Ridge, pp 1–11
39.
Maraire JN, Awad IA (1995) Intracranial cavernous malformations: lesion behavior and management strategies. Neurosurgery 37:591–605CrossRefPubMed
40.
Haacke EM, Mittal S, Wu Z et al (2009) Susceptibility-weighted imaging: technical aspects and clinical applications, part 1. AJNR Am J Neuroradiol 30:19–30CrossRefPubMed
41.
Jain R, Robertson PL, Gandhi D et al (2005) Radiation-induced cavernomas of the brain. AJNR Am J Neuroradiol 26:1158–1162PubMed
42.
Sasaki O, Tanaka R, Koike T et al (1991) Excision of cavernous angioma with preservation of coexisting venous angioma. Case report. J Neurosurg 75:461–464CrossRefPubMed
43.
Bertalanffy H, Gilsbach JM, Eggert HR, Seeger W (1991) Microsurgery of deep-seated cavernous angiomas: report of 26 cases. Acta Neurochir (Wien) 108:91–99CrossRef
44.
Buhl R, Hempelmann RG, Stark AM, Mehdorn HM (2002) Therapeutical considerations in patients with intracranial venous angiomas. Eur J Neurol 9:165–169CrossRefPubMed
45.
Crivelli G, Dario A, Cerati M, Dorizzi A (2002) Third ventricle cavernoma associated with venous angioma. Case report and review of the literature. J Neurosurg Sci 46:127–130PubMed
46.
Dorsch N, McMahon J (1998) Intracranial cavernous malformations - natural history and management. Crit Rev Neurosurg 8:154–168CrossRefPubMed
47.
Pozzati E, Acciarri N, Tognetti F et al (1996) Growth, subsequent bleeding, and de novo appearance of cerebral cavernous angiomas. Neurosurgery 38:662–669, discussion 669–70
Metadata
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
Authors
Burak Kocak
Osman Kizilkilic
Buge Oz
Dogu Vuralli Bakkaloglu
Cihan Isler
Naci Kocer
Civan Islak
Publication date
01-06-2017
Publisher
Springer Berlin Heidelberg
Published in
European Radiology / Issue 6/2017
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-016-4595-9

Other articles of this Issue 6/2017

European Radiology 6/2017 Go to the issue

Urogenital

ESUR recommendations for MR imaging of the sonographically indeterminate adnexal mass: an update

Magnetic Resonance

Whole-body MRI in patients with Non-bacterial Osteitis: Radiological findings and correlation with clinical data

Gastrointestinal

Diffusion-weighted MR enterography for evaluating Crohn’s disease: Effect of anti-peristaltic agent on the diagnosis of bowel inflammation

Magnetic Resonance

Combined MR direct thrombus imaging and non-contrast magnetic resonance venography reveal the evolution of deep vein thrombosis: a feasibility study

Neuro

Substantia nigra fractional anisotropy is not a diagnostic biomarker of Parkinson’s disease: A diagnostic performance study and meta-analysis

Oncology

Dual energy CT allows for improved characterization of response to antiangiogenic treatment in patients with metastatic renal cell cancer