The association between cerebral developmental venous anomaly and concomitant cavernous malformation: an observational study using magnetic resonance imaging

Guolu Meng,Chuanfeng Bai,Tengfei Yu,Junting Zhang,Zhen Wu,Jizong Zhao,Xing Liu

doi:10.1186/1471-2377-14-50

Guolu Meng, Chuanfeng Bai + Show 5 more

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https://doi.org/10.1186/1471-2377-14-50

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Abstract

BackgroundSome studies reported that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). But there is lack of statistical evidence and study of bulk cases. The factors associated with concurrency are still unknown. The purpose of this study was to determine the prevalence of concomitant DVA and CM using observational data on Chinese patients and analyze the factors associated with the concurrency.MethodsThe records of all cranial magnetic resonance imaging (MRI) performed between January 2001 and December 2012 in Beijing Tiantan Hospital were reviewed retrospectively. The DVA and CM cases were selected according to imaging reports that met diagnostic criteria. Statistical analysis was performed using the Pearson chi-square statistic for binary variables and multivariable logistic regression analysis for predictors associated with the concurrent CM.ResultsWe reviewed a total of 165,230 cranial MR images performed during the previous 12 year period, and identified 1,839 cases that met DVA radiographic criteria. There were 205 patients who presented concomitant CM among the 1,839 DVAs. The CM prevalence in DVA cases (11.1%) was significantly higher than that in the non-DVA cases (2.3%) (P<0.01). In the multivariate analysis, we found that DVAs with three or more medullary veins in the same MRI section (adjusted OR = 2.37, 95% CI: 1.73-3.24), infratentorial DVAs (adjusted OR = 1.71, 95% CI: 1.26-2.33) and multiple DVAs (adjusted OR = 2.08, 95% CI: 1.04-4.16) have a higher likelihood of being concomitant with CM.ConclusionsCM are prone to coexisting with DVA. There is a higher chance of concurrent CM with DVA when the DVA has three or more medullary veins in the same MRI scanning section, when the DVA is infratentorial, and when there are multiple DVAs. When diagnosing DVA cases, physicians should be alerted to the possibility of concurrent CM.

Highlights

Some studies reported that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM)
Among the 1,839 DVA cases,a subgroup of 205 (11.15%) cases presented with concomitant CM
We found 388 (21.10%) DVA cases with three or more medullary veins visible simultaneously in at least one section of magnetic resonance imaging (MRI), and 1,451 (78.90%) DVA cases with fewer than three medullary veins in any single MRI section

Summary

Introduction

Some studies reported that cerebral developmental venous anomaly (DVA) is often concurrent with cavernous malformation (CM). The factors associated with concurrency are still unknown. The purpose of this study was to determine the prevalence of concomitant DVA and CM using observational data on Chinese patients and analyze the factors associated with the concurrency. Cerebral vascular malformation (CVM) is a class of important central nervous system diseases. According to Russell and Rubinstein’s standard, there are four major types of vascular malformations of the central nervous system: developmental venous anomaly (DVA), cavernous malformation (CM), arteriovenous malformation, and capillary telangiectasia [1]. DVAs have a benign clinical course [6], and the reported incidence is 0.05-3% based on enhanced imaging and autopsy in the general population [6,7,8,9,10]. The pathogenesis of CM includes pathological factors as well as genetic mutation [13]

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