Aims and objectives
There are multiple classifications for vascular abnormalities.
The newest is “ISSVA classification for vascular anomalies” (Table 1) which is based on the founding biological investigation of Mulliken and Glowacki published in 1982.
More simply,
malformations can be categorized as either low-flow or high-flow lesions on the basis of their hemodynamic flow characteristics.
The distinction between low- and high-flow lesions is crucial because it determines appropriate patient treatment,
namely sclerotherapy for low-flow lesions or embolization for high-flow lesions.
Dynamic time-resolved MR angiography has been proven to...
Methods and materials
We evaluated data for 25 consecutive patients with diagnosed vascular malformations who were examined in our MRI faculty between January 2011 and December 2013.
A detailed description of the study group is given in Table 2.
On the basis of selective digital subtraction angiography (DSA) examinations and patient clinical data (including color doppler imaging results),
malformations were divided into two groups: high flow and low flow.
MR imaging Technique
The MR examinations were performed on a 1.5-T scanner.
The study protocol consisted of T1-weighted,
turbo...
Results
Of the 25 patients for whom data were evaluated,
7 were found to have high-flow malformations and 18 had low-flow malformations.
Signal voids on SE T1-weighted images were observed in only four of seven high-flow malformations (Fig.
4).
Signal voids were also observed in two of the 18 low-flow malformations.
The sensitivity and specificity of this method to distinguish between high- and low-flow malformations was 57% and 89%,
respectively.
Analysis of signal intensity on T2-weighted images showed increased signal intensity in 17 of 18 low-flow...
Conclusion
MRI is the established method of choice for the imaging of vascular malformations.
In addition to morphological findings on T1- and T2-weighted imaging,
3D time-resolved angiography can improve diagnosis.
However,
the criteria used to classify malformations as high-flow or low-flow lesions vary considerably between studies.
In the present study we evaluated previously described methods of classification,
as well as a new method based on the slope of the enhancement curve.
The results indicate that none of the previously described methods allowed for the discrimination of...
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