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Journal of Pediatric Neurology 2022; 20(02): 103-108
DOI: 10.1055/s-0041-1736554
Original Article

Diagnostic Accuracy of SWAN in the Diagnosis of Low-Flow Brain Vascular Malformations in Childhood

Nazlı Gülsüm Akyel 
1   Department of Pediatric Radiology, Sanliurfa Training and Research Hospital, Şanliurfa, Turkey
,
Ayşe Gül Alımlı
2   Department of Pediatric Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
,
Mesut Sivri
3   Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
,
Havva Akmaz Ünlü
3   Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
,
Mehmet Tiftik
3   Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
› Institutsangaben Funding None.
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Abstract

Purpose The main objective of this study is to demonstrate the diagnostic accuracy of susceptibility-weighted angiography (SWAN) in the diagnosis of slow-flow cerebral vascular malformations, especially developmental venous anomaly (DVA). We also aimed to determine the prevalence of DVAs identified by SWAN at 1.5 T.

Methods We retrospectively evaluated 1,760 axial SWAN images for the diagnosis of low-flow vascular anomaly. Among them were 305 patients who underwent contrast-enhanced examination due to different indications. Postcontrast images were analyzed by different radiologists who were blinded to patients. The presence of DVA and other features such as location, length, depth, and direction of drainage vein was evaluated.

Results Twenty-six patients with DVA had both SWAN and postcontrast images. There were four false-negative patients with SWAN. The sensitivity of the SWAN sequence was 84.6%. In addition, totally 77 DVA (4.36%), 2 capillary telangiectasia (0.11%), and 2 cavernous malformations (0.11%) were detected in 1,760 patients.

Conclusion SWAN is an effective method for the diagnosis of developmental venous anomalies and other low-flow cerebral vascular malformations. Especially in the pediatric age, susceptibility-weighted imaging sequences are useful to limit contrast use.

Keywords

developmental venous anomaly - cavernous angiomas - capillary telangiectasia - susceptibility-weighted angiography - susceptibility-weighted imaging - magnetic resonance imaging

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


Availability of Data and Material

Data and materials are available in PACs system and in our Excel files.




Publikationsverlauf

Eingereicht: 14. April 2021

Angenommen: 16. September 2021

Artikel online veröffentlicht:
25. Oktober 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

  • References

  • 1 Bosemani T, Verschuuren SI, Poretti A, Huisman TA. Pitfalls in susceptibility-weighted imaging of the pediatric brain. J Neuroimaging 2014; 24 (03) 221-225
    CrossrefPubMedGoogle Scholar
  • 2 Sarwar M, McCormick WF. Intracerebral venous angioma. Case report and review. Arch Neurol 1978; 35 (05) 323-325
    CrossrefPubMedGoogle Scholar
  • 3 Gökçe E, Acu B, Beyhan M, Celikyay F, Celikyay R. Magnetic resonance imaging findings of developmental venous anomalies. Clin Neuroradiol 2014; 24 (02) 135-143
    CrossrefPubMedGoogle Scholar
  • 4 Huisman TA, Singhi S, Pinto PS. Non-invasive imaging of intracranial pediatric vascular lesions. Childs Nerv Syst 2010; 26 (10) 1275-1295
    CrossrefPubMedGoogle Scholar
  • 5 Acciarri N, Galassi E, Giulioni M. et al. Cavernous malformations of the central nervous system in the pediatric age group. Pediatr Neurosurg 2009; 45 (02) 81-104
    CrossrefPubMedGoogle Scholar
  • 6 Reichenbach JR, Haacke EM. High-resolution BOLD venographic imaging: a window into brain function. NMR Biomed 2001; 14 (7-8): 453-467
    CrossrefPubMedGoogle Scholar
  • 7 Sehgal V, Delproposto Z, Haacke EM. et al. Clinical applications of neuroimaging with susceptibility-weighted imaging. J Magn Reson Imaging 2005; 22 (04) 439-450
    CrossrefPubMedGoogle Scholar
  • 8 Lummel N, Boeckh-Behrens T, Schoepf V, Burke M, Brückmann H, Linn J. Presence of a central vein within white matter lesions on susceptibility weighted imaging: a specific finding for multiple sclerosis?. Neuroradiology 2011; 53 (05) 311-317
    CrossrefPubMedGoogle Scholar
  • 9 Kunimatsu A, Suzuki Y, Hagiwara K. et al. Clinical value of 3D T2*-weighted imaging with multi-echo acquisition: comparison with conventional 2D T2*-weighted imaging and 3D phase-sensitive MR imaging. Magn Reson Med Sci 2012; 11 (03) 205-211
    CrossrefPubMedGoogle Scholar
  • 10 Ruíz DS, Yilmaz H, Gailloud P. Cerebral developmental venous anomalies: current concepts. Ann Neurol 2009; 66 (03) 271-283
    CrossrefPubMedGoogle Scholar
  • 11 Ramalho J, Semelka RC, Ramalho M, Nunes RH, AlObaidy M, Castillo M. Gadolinium-based contrast agent accumulation and toxicity: an update. Am J Neuroradiol 2016; 37 (07) 1192-1198
    CrossrefPubMedGoogle Scholar
  • 12 Takasugi M, Fujii S, Shinohara Y, Kaminou T, Watanabe T, Ogawa T. Parenchymal hypointense foci associated with developmental venous anomalies: evaluation by phase-sensitive MR imaging at 3T. Am J Neuroradiol 2013; 34 (10) 1940-1944
    CrossrefPubMedGoogle Scholar
  • 13 Linscott LL, Leach JL, Zhang B, Jones BV. Brain parenchymal signal abnormalities associated with developmental venous anomalies in children and young adults. Am J Neuroradiol 2014; 35 (08) 1600-1607
    CrossrefPubMedGoogle Scholar
  • 14 Boeckh-Behrens T, Lutz J, Lummel N. et al. Susceptibility-weighted angiography (SWAN) of cerebral veins and arteries compared to TOF-MRA. Eur J Radiol 2012; 81 (06) 1238-1245
    CrossrefPubMedGoogle Scholar
  • 15 Haacke EM, Mittal S, Wu Z, Neelavalli J, Cheng YC. Susceptibility-weighted imaging: technical aspects and clinical applications, part 1. Am J Neuroradiol 2009; 30 (01) 19-30
    CrossrefPubMedGoogle Scholar
  • 16 Mittal S, Wu Z, Neelavalli J, Haacke EM. Susceptibility-weighted imaging: technical aspects and clinical applications, part 2. Am J Neuroradiol 2009; 30 (02) 232-252
    CrossrefPubMedGoogle Scholar
  • 17 Essig M, Reichenbach JR, Schad LR, Schoenberg SO, Debus J, Kaiser WA. High-resolution MR venography of cerebral arteriovenous malformations. Magn Reson Imaging 1999; 17 (10) 1417-1425
    CrossrefPubMedGoogle Scholar
  • 18 Young A, Poretti A, Bosemani T, Goel R, Huisman TAGM. Sensitivity of susceptibility-weighted imaging in detecting developmental venous anomalies and associated cavernomas and microhemorrhages in children. Neuroradiology 2017; 59 (08) 797-802
    CrossrefPubMedGoogle Scholar
  • 19 San Millán Ruíz D, Delavelle J, Yilmaz H. et al. Parenchymal abnormalities associated with developmental venous anomalies. Neuroradiology 2007; 49 (12) 987-995
    CrossrefPubMedGoogle Scholar
  • 20 Rosa M, Borzone M. The venous system of the corpus striatum. Angiographic study. Neuroradiology 1973; 6 (04) 219-230
    CrossrefPubMedGoogle Scholar
  • 21 Uchino A, Hasuo K, Matsumoto S, Masuda K. Double cerebral venous angiomas: MRI. Neuroradiology 1995; 37 (01) 25-28
    CrossrefPubMedGoogle Scholar
  • 22 Iwasaki H, Fujita Y, Hara M. Susceptibility-weighted imaging in acute-stage pediatric convulsive disorders. Pediatr Int 2015; 57 (05) 922-929
    CrossrefPubMedGoogle Scholar
  • 23 Ohno K, Saito Y, Togawa M. et al. Evolution of a symptomatic diffuse developmental venous anomaly with progressive cerebral atrophy in an atypical case of Sturge-Weber syndrome. Brain Dev 2015; 37 (08) 817-821
    CrossrefPubMedGoogle Scholar
  • 24 Shenton ME, Hamoda HM, Schneiderman JS. et al. A review of magnetic resonance imaging and diffusion tensor imaging findings in mild traumatic brain injury. Brain Imaging Behav 2012; 6 (02) 137-192
    CrossrefPubMedGoogle Scholar