Developmental venous anomalies: appearance on whole-brain CT digital subtraction angiography and CT perfusionReport as inadecuate

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, Volume 53, Issue 5, pp 331–341

First Online: 23 July 2010Received: 22 April 2010Accepted: 23 June 2010


IntroductionDevelopmental venous anomalies DVA consist of dilated intramedullary veins that converge into a large collecting vein. The appearance of these anomalies was evaluated on whole-brain computed tomography CT digital subtraction angiography DSA and CT perfusion CTP studies.

MethodsCT data sets of ten anonymized patients were retrospectively analyzed. Five patients had evidence of DVA and five age- and sex-matched controls were without known neurovascular abnormalities. CT angiograms, CT arterial-venous views, 4-D CT DSA and CTP maps were acquired on a dynamic volume imaging protocol on a 320-detector row CT scanner. Whole-brain CTP parameters were evaluated for cerebral blood flow CBF, cerebral blood volume CBV, time to peak TTP, mean transit time MTT, and delay. DSA was utilized to visualize DVA anatomy. Radiation dose was recorded from the scanner console.

ResultsIncreased CTP values were present in the DVA relative to the unaffected contralateral hemisphere of 48%, 32%, and 26%; and for the control group with matched hemispheric comparisons of 2%, −10%, and 9% for CBF, CBV, and MTT, respectively. Average effective radiation dose was 4.4 mSv.

ConclusionWhole-brain DSA and CTP imaging can demonstrate a characteristic appearance of altered DVA hemodynamic parameters and capture the anomalies in superior cortices of the cerebrum and the cerebellum. Future research may identify the rare subsets of patients at increased risk of adverse outcomes secondary to the altered hemodynamics to facilitate tailored imaging surveillance and application of appropriate preventive therapeutic measures.

KeywordsComputed tomography CT angiography CT perfusion Developmental venous anomalies Whole-brain CT perfusion  Download fulltext PDF

Author: Eric H. Hanson - Cayce J. Roach - Erik N. Ringdahl - Brad L. Wynn - Sean M. DeChancie - Nathan D. Mann - Alan S. Dia


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