Clinical application value of whole-brain CTA-CTP imaging in cerebral arteriovenous malformation / 实用放射学杂志

ABSTRACT

Objective To explore the clinical application value of whole-brain CTA-CTP imaging in cerebral arteriovenous malformation (cAVM).Methods Fifteen patients diagnosed with cAVM by CTA-CTP imaging were included in this retrospective analysis study. The angioarchitecture of cAVM lesions were recorded from 4D-CTA images.Using DSA as the golden standard,the diagnostic accuracy of 4D-CTA was evaluated in 13 cases.The perfusion patterns of vessel nidus and peritumoral tissues were analyzed from the CTP images.Bleeding ratios of patients with different angioarchitecture and perfusion patterns were compared.Results 4D-CTA could dynamically display the angioarchitecture details of cAVM lesions and show the whole process of the contrast agent in and out of the vessel nidus.Although the result of 4D-CTA was consistent with that of DSA in most cases,a few fine feeding arteries and draining veins were missed.The nidus in thirteen cases was with high perfusion and the peritumoral tissues were with low perfusion.Another two cases were with low perfusion due to the presence of hematoma.Nine cAVMs suffered from small size,single feeding artery,deep venous drainage and vessel nidus with increased MTT,peritumoral tissues with decreased MTT were more likely to suffer a hemorrhage (P<0.05).Conclusion Whole-brain CTA-CTP imaging could be a valuable adjunct in noninvasive diagnosis of cAVM and predicting the bleeding risk factors.