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Observational Study
. 2014 Mar 15:14:50.
doi: 10.1186/1471-2377-14-50.

The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging

Guolu Meng, Chuanfeng Bai, Tengfei Yu, Zhen Wu  1 , Xing Liu, Junting Zhang, Jizong zhao
Affiliations
Observational Study

The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging

Guolu Meng et al. BMC Neurol. .

Abstract

Background: Some studies reported that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). But there is lack of statistical evidence and study of bulk cases. The factors associated with concurrency are still unknown. The purpose of this study was to determine the prevalence of concomitant DVA and CM using observational data on Chinese patients and analyze the factors associated with the concurrency.

Methods: The records of all cranial magnetic resonance imaging (MRI) performed between January 2001 and December 2012 in Beijing Tiantan Hospital were reviewed retrospectively. The DVA and CM cases were selected according to imaging reports that met diagnostic criteria. Statistical analysis was performed using the Pearson chi-square statistic for binary variables and multivariable logistic regression analysis for predictors associated with the concurrent CM.

Results: We reviewed a total of 165,230 cranial MR images performed during the previous 12 year period, and identified 1,839 cases that met DVA radiographic criteria. There were 205 patients who presented concomitant CM among the 1,839 DVAs. The CM prevalence in DVA cases (11.1%) was significantly higher than that in the non-DVA cases (2.3%) (P<0.01). In the multivariate analysis, we found that DVAs with three or more medullary veins in the same MRI section (adjusted OR = 2.37, 95% CI: 1.73-3.24), infratentorial DVAs (adjusted OR = 1.71, 95% CI: 1.26-2.33) and multiple DVAs (adjusted OR = 2.08, 95% CI: 1.04-4.16) have a higher likelihood of being concomitant with CM.

Conclusions: CM are prone to coexisting with DVA. There is a higher chance of concurrent CM with DVA when the DVA has three or more medullary veins in the same MRI scanning section, when the DVA is infratentorial, and when there are multiple DVAs. When diagnosing DVA cases, physicians should be alerted to the possibility of concurrent CM.

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Figures

Figure 1
Figure 1
Supratentorial DVA and Concomitant CM. A: Enhanced MRI image showing the DVA and the CM which locates at the distal radicles of the DVA. B: CM shows classic heterogeneous “popcorn” appearance on T2-weighted image. C: Post-operation image showing that the CM disappeared. D: Pathological picture of the CM showing the sinusoidal vascular channels.
Figure 2
Figure 2
Subtentorial DVA and Concomitant CM. A and B. Enhanced MRI images showing irregular “caput medusae” in the left cerebellar hemisphere and pons, and the CM locates at the distal radicles of the DVA.
See this image and copyright information in PMC

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