Multiparametric Magnetic Resonance Imaging Features That Predict Treatment Response to Endovascular Sclerotherapy in Craniofacial Venous Malformations

Abstract

Craniofacial venous malformations (VMs) cause severe psychological and physiological burden to patients, and treatment is meaningful only when the benefits of treatment outweigh the risks. Therefore, it is very important to predict the treatment response before treatment. This study was performed to explore the value of multiparametric magnetic resonance imaging for predicting treatment response to endovascular sclerotherapy in VMs. We designed and implemented a case-control study and enrolled a sample from patients with VM treated by endovascular sclerotherapy at our hospital from January 2014 to January 2018. The primary predictor variables were pretreatment volume (prevolume), lesion classification, phleboliths, initial slope of increase (ISI), gender, age, and sclerosants. The primary outcome variable was treatment response (positive response or negative response). Descriptive, univariate and multivariate binary logistic regressions, and Firth's penalized maximum likelihood estimate were computed to measure the association between predictor variables and treatment response. The level of statistical significance was set at a P value less than or equal to .05. The sample was composed of 42 patients with a median age of 17.50years, and 33.3% were males. There were 27 and 15 patients in the positive and negative response groups, respectively. There were significant differences between the 2 groups for ISI (adjusted odds ratio [OR], 2.184; P=.0268; 95% confidence interval [95% CI], 1.094 to 4.360), lesion classification (adjusted OR, 9.072; P=.0226; 95% CI, 1.363 to 60.400), and prevolume (adjusted OR, 1.020; P=.0268; 95% CI, 1.002 to 1.038). The cutoff point for prevolume and ISI was 40.42cm3 and 2.61. Multiparametric magnetic resonance imaging could provide an approach for predicting treatment response in craniofacial VMs. When the prevolume was greater than 40.42cm3, ISI was greater than 2.61, and the classification was infiltrating type, the response to sclerotherapy was negative.