HEMORRHAGE IN INTRACEREBRAL ARTERIOVENOUS-MALFORMATIONS - ANGIOGRAPHIC DETERMINANTS

被引:212
作者
MARKS, MP [1 ]
LANE, B [1 ]
STEINBERG, GK [1 ]
CHANG, PJ [1 ]
机构
[1] STANFORD UNIV,MED CTR,DEPT NEUROSURG,STANFORD,CA 94305
关键词
D O I
10.1148/radiology.176.3.2389040
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
The most serious and frequent complication of intracranial arteriovenous malformations (AVMs) is intracranial hemorrhage. Identification of patients at greatest risk for intracranial bleeding would be beneficial. Detailed analysis of vascular architecture was performed in 65 patients with intracranial AVMs to identify the vascular characteristics that correlated with hemorrhage. Fifteen characteristics were assessed. Hemorrhage was present in 45 patients (69%). The following characteristics correlated positively with hemorrhage (Fisher-Irwin exact test): central venous drainage (P < .0001), periventricular or intraventricular locataion of the AVM (P = .0002), and intranidal aneurysm (P = .028). The following characteristics correlated negatively with hemorrhage: angiomatous change (P = .0005), peripheral venous drainage (P = .005), and mixed venous drainage (P = .021). Multivariate linear discriminant analysis demonstrated that central venous drainage, angiomatous change (negatively predictive), intranidal aneurysm, and periventricular or intraventricular location of the AVM were the most discriminating or predictive characteristics of hemorrhage. Detailed analysis of the vascular architecture of intracranial AVMs helped identify features that strongly correlate with clinical hemorrhage and have important prognostic implications for the treatment of patients with these lesions.
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页码:807 / 813
页数:7
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