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A rupture risk analysis of cerebral cavernous malformation associated with developmental venous anomaly using susceptibility-weighted imaging

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Purpose

To search for the risk factors closely related to cerebral cavernous malformation associated with developmental venous anomaly (CCM-DVA) lesions rupture, laying foundations for the development of reasonable individual treatment plans for patients.

Methods

In this retrospective study, we collected CCM-DVA patients who met the inclusion criteria in our outpatient department from 2014 to 2017, MRI scans were performed including susceptibility-weighted imaging (SWI) and contrast-enhanced imaging, characteristics and basic clinical information were collected then statistically analyzed, CCM-DVA lesions were divided into 3 types according to the location and quantitative relationship between CCM and DVA.

Results

A total number of 319 adult patients were identified with 41.2±11.9 years on average, though univariate and multivariate regression analysis, ruptured presentations were more common in patients with prior hemorrhage (p=0.003), type III CCM-DVA lesions (p=0.001), lesions volume>1 cm3 (p<0.001), infratentorial lesions especially located in midbrain (p=0.019), pontine (p=0.007), medulla (p=0.015). Caplan-Meier curve shows a lower Hemorrhage-free survival rate on patients with type III CCM-DVA lesions (log-rank, p=0.0222), functional area lesions (log-rank, p<0.001), lesions volume>1 cm3 (log-rank, p<0.001), infratentorial lesions (log-rank, p=0.0002).

Conclusion

The classification based on the relationship between CCM and DVA may be meaningful to predict the risk of lesion rupture and CCM lesions next to DVA distal branches showed a higher risk of rupture.

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Funding

This study was funded by the National Natural Science Foundation of China (81371292) and the National Natural Science Foundation of China (H0906 81801140).

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Authors and Affiliations

  1. Department of Neurosurgery, Capital Medical University Affiliated Beijing Tiantan Hospital, Beijing, People’s Republic of China

    Shuo Zhang, Li Ma, Jun Wu, Yong Cao, Shuo Wang & Jizong Zhao

  2. China National Clinical Research Center for Neurological Diseases, Beijing, People’s Republic of China

    Shuo Zhang, Li Ma, Jun Wu, Yong Cao, Shuo Wang & Jizong Zhao

  3. Department of Neuroradiology, Capital Medical University Affiliated Beijing Tiantan Hospital, Beijing, China

    Chunxue Wu

Authors
  1. Shuo Zhang
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  2. Li Ma
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  3. Chunxue Wu
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  5. Yong Cao
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Correspondence to Jizong Zhao.

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Zhang, S., Ma, L., Wu, C. et al. A rupture risk analysis of cerebral cavernous malformation associated with developmental venous anomaly using susceptibility-weighted imaging. Neuroradiology 62, 39–47 (2020). https://doi.org/10.1007/s00234-019-02274-1

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  • DOI: https://doi.org/10.1007/s00234-019-02274-1

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