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Sensitivity of susceptibility-weighted imaging in detecting developmental venous anomalies and associated cavernomas and microhemorrhages in children

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Abstract

Purpose

Developmental venous anomalies (DVA) are common neuroimaging abnormalities that are traditionally diagnosed by contrast-enhanced T1-weighted images as the gold standard. We aimed to evaluate the sensitivity of SWI in detecting DVA and associated cavernous malformations (CM) and microhemorrhages in children in order to determine if SWI may replace contrast-enhanced MRI sequences.

Methods

Contrast-enhanced T1-weighted images were used as diagnostic gold standard for DVA. The presence of DVA was qualitatively assessed on axial SWI and T2-weighted images by an experienced pediatric neuroradiologist. In addition, the presence of CM and microhemorrhages was evaluated on SWI and contrast-enhanced T1-weighted images.

Results

Fifty-seven children with DVA (34 males, mean age at neuroimaging 11.2 years, range 1 month to 17.9 years) were included in this study. Forty-nine out of 57 DVA were identified on SWI (sensitivity of 86%) and 16 out of 57 DVA were detected on T2-weighted images (sensitivity of 28.1%). General anesthesia-related changes in brain hemodynamics and oxygenation were most likely responsible for the majority of SWI false negative. CM were detected in 12 patients on axial SWI, but only in six on contrast-enhanced T1-weighted images. Associated microhemorrhages could be identified in four patients on both axial SWI and contrast-enhanced T1-weighted images, although more numerous and conspicuous on SWI.

Conclusion

SWI can identify DVA and associated cavernous malformations and microhemorrhages with high sensitivity, obviating the need for contrast-enhanced MRI sequences.

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References

  1. Gokce E, Acu B, Beyhan M, Celikyay F, Celikyay R (2014) Magnetic resonance imaging findings of developmental venous anomalies. Clin Neuroradiol 24:135–143

    Article  CAS  PubMed  Google Scholar 

  2. Ruiz DS, Yilmaz H, Gailloud P (2009) Cerebral developmental venous anomalies: current concepts. Ann Neurol 66:271–283

    Article  PubMed  Google Scholar 

  3. San Millan Ruiz D, Gailloud P (2010) Cerebral developmental venous anomalies. Childs Nerv Syst 26:1395–1406

    Article  PubMed  Google Scholar 

  4. Linscott LL, Leach JL, Zhang B, Jones BV (2014) Brain parenchymal signal abnormalities associated with developmental venous anomalies in children and young adults. AJNR Am J Neuroradiol 35:1600–1607

    Article  CAS  PubMed  Google Scholar 

  5. Acciarri N, Galassi E, Giulioni M, Pozzati E, Grasso V, Palandri G, Badaloni F, Zucchelli M, Calbucci F (2009) Cavernous malformations of the central nervous system in the pediatric age group. Pediatr Neurosurg 45:81–104

    Article  PubMed  Google Scholar 

  6. Huisman TA, Singhi S, Pinto PS (2010) Non-invasive imaging of intracranial pediatric vascular lesions. Childs Nerv Syst 26:1275–1295

    Article  PubMed  Google Scholar 

  7. Linscott LL, Leach JL, Jones BV, Abruzzo TA (2016) Developmental venous anomalies of the brain in children—imaging spectrum and update. Pediatr Radiol 46:394–406

    Article  PubMed  Google Scholar 

  8. Ramalho J, Semelka RC, Ramalho M, Nunes RH, Alobaidy M, Castillo M (2016) Gadolinium-based contrast agent accumulation and toxicity: an update. AJNR Am J Neuroradiol 37:1192–1198

    Article  CAS  PubMed  Google Scholar 

  9. Stojanov D, Aracki-Trenkic A, Benedeto-Stojanov D (2016) Gadolinium deposition within the dentate nucleus and globus pallidus after repeated administrations of gadolinium-based contrast agents-current status. Neuroradiology 58:433–441

    Article  PubMed  Google Scholar 

  10. Semelka RC, Ramalho M, AlObaidy M, Ramalho J (2016) Gadolinium in humans: a family of disorders. AJR Am J Roentgenol:W1–W5

  11. Tong KA, Ashwal S, Obenaus A, Nickerson JP, Kido D, Haacke EM (2008) Susceptibility-weighted MR imaging: a review of clinical applications in children. AJNR Am J Neuroradiol 29:9–17

    Article  CAS  PubMed  Google Scholar 

  12. Bosemani T, Poretti A, Huisman TA (2014) Susceptibility-weighted imaging in pediatric neuroimaging. J Magn Reson Imaging 40:530–544

    Article  PubMed  Google Scholar 

  13. Zabramski JM, Wascher TM, Spetzler RF, Johnson B, Golfinos J, Drayer BP, Brown B, Rigamonti D, Brown G (1994) The natural history of familial cavernous malformations: results of an ongoing study. J Neurosurg 80:422–432

    Article  CAS  PubMed  Google Scholar 

  14. Kondziolka D, Lunsford LD, Kestle JR (1995) The natural history of cerebral cavernous malformations. J Neurosurg 83:820–824

    Article  CAS  PubMed  Google Scholar 

  15. Moriarity JL, Wetzel M, Clatterbuck RE, Javedan S, Sheppard JM, Hoenig-Rigamonti K, Crone NE, Breiter SN, Lee RR, Rigamonti D (1999) The natural history of cavernous malformations: a prospective study of 68 patients. Neurosurgery 44:1166–1171 discussion 1172-1163

    CAS  PubMed  Google Scholar 

  16. Wurm G, Schnizer M, Fellner FA (2005) Cerebral cavernous malformations associated with venous anomalies: surgical considerations. Neurosurgery 57:42–58

    Article  PubMed  Google Scholar 

  17. Sedlacik J, Lobel U, Kocak M, Loeffler RB, Reichenbach JR, Broniscer A, Patay Z, Hillenbrand CM (2010) Attenuation of cerebral venous contrast in susceptibility-weighted imaging of spontaneously breathing pediatric patients sedated with propofol. AJNR Am J Neuroradiol 31:901–906

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  18. Bosemani T, Verschuuren SI, Poretti A, Huisman TA (2014) Pitfalls in susceptibility-weighted imaging of the pediatric brain. J Neuroimaging 24:221–225

    Article  PubMed  Google Scholar 

  19. Amemiya S, Aoki S, Takao H (2008) Venous congestion associated with developmental venous anomaly: findings on susceptibility weighted imaging. J Magn Reson Imaging 28:1506–1509

    Article  PubMed  Google Scholar 

  20. Takasugi M, Fujii S, Shinohara Y, Kaminou T, Watanabe T, Ogawa T (2013) Parenchymal hypointense foci associated with developmental venous anomalies: evaluation by phase-sensitive MR imaging at 3T. AJNR Am J Neuroradiol 34:1940–1944

    Article  CAS  PubMed  Google Scholar 

  21. Frischer JM, God S, Gruber A, Saringer W, Grabner G, Gatterbauer B, Kitz K, Holzer S, Kronnerwetter C, Hainfellner JA, Knosp E, Trattnig S (2012) Susceptibility-weighted imaging at 7 T: improved diagnosis of cerebral cavernous malformations and associated developmental venous anomalies. Neuroimage Clin 1:116–120

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

We would like to thank Dr. Bruno P. Soares for his critical review of this manuscript.

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Correspondence to Thierry A. G. M. Huisman.

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No funding was received for this study.

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The authors declare that they have no conflict of interest.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of retrospective study formal consent is not required.

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For this type of retrospective study formal consent is not required.

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Young, A., Poretti, A., Bosemani, T. et al. Sensitivity of susceptibility-weighted imaging in detecting developmental venous anomalies and associated cavernomas and microhemorrhages in children. Neuroradiology 59, 797–802 (2017). https://doi.org/10.1007/s00234-017-1867-2

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  • DOI: https://doi.org/10.1007/s00234-017-1867-2

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