Learning objectives
To understand the MR imaging appearances of arterio-venous malformations in the brain and spine.
To learn the possible complications of arterio-venous malformations.
To observe the MR imaging appearance of treated arterio-venous malformations.
Background
Overview
Arterio-venous malformations represent anomalous connections between arteries and veins through a disorganised tangle of small vessels called nidus and are a circulation wherein blood bypasses the capillaries and goes directly from arteries to veins.
Clinical features(1)
Usually arterio-venous malformations are asymptomatic; however they may present with headache,
numbness,
weakness etc.
depending on their location and extent of bleeding.
Inpatients who present without haemorrhage,
clinical presentations include:
Seizures
Headache
Muscle weakness or numbness
Depending on the location of the AVMs,
patients can have more serious...
Findings and procedure details
Summary.
MRI protocol included T1,
T2,
FLAIR,
DWI and SWI sequences for all 11 patients out of which post contrast T1 weighted images were available for 7 patients.
10 of these patients presented with cerebral lesions and one of them was imaged post embolization.
1 patient presented with a spinal arterio-venous malformation.
Flow voids,
feeder arteries,
large draining veins,
tangle of blood vessels,
vascular loops and mass effect were some of the major findings that were observed.
Other findings included signal changes and blooming artifacts...
Conclusion
AV malformations can occur in any part of the body and two of the main locations are described in this educational exhibit.
Usually arterio-venous malformations are diagnosed on MRI but contrast enhanced CT and angiography may also help in making the diagnosis.
It is important to diagnose these arterio-venous malformations and their complications to help the clinicians make correct decisions for their management.
Personal information
Dr.
Vendoti Nitheesha Reddy
Final year Resident
Department of Radio-diagnosis and Imaging
Ramaiah Medical College and Hospitals
Bangalore - 560054.
Email:
[email protected]
Dr.
Pannag Desai
Senior Resident
Department of Radio-diagnosis and Imaging
Ramaiah Medical College and Hospitals
Bangalore - 560054.
Email:
[email protected]
Dr.
Ashok kumar A.
Professor and Head of Department
Department of Radio-diagnosis and Imaging
Ramaiah Medical College and Hospitals
Bangalore - 560054.
Email:
[email protected]
References
Brain AVM (arteriovenous malformation) - Symptoms and causes [Internet].
Mayo Clinic.
2019 [cited 6 January 2019].
Available from: https://www.mayoclinic.org/diseases-conditions/brain-avm/symptoms-causes/syc-20350260.
R.
M.
Friedlander,
“Arteriovenous malformations of the brain,” e New England Journal of Medicine,
vol.
356,
no.
26,
pp.
2704– 2712,
2007.
Minami S,
Sagoh T,
Nishimura K et-al.
Spinal arteriovenous malformation: MR imaging.
Radiology.
1988;169 (1): 109-15.Radiology (abstract)-Pubmed citation
Doppman JL,
Di chiro G,
Oldfield EH.
Origin of spinal arteriovenous malformation and normal cord vasculature from a common segmental artery: angiographic and therapeutic considerations.
Radiology....