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首页> 外文期刊>Neurosurgery >Study of magnetic resonance imaging-based arteriovenous malformation delineation without conventional angiography.
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Study of magnetic resonance imaging-based arteriovenous malformation delineation without conventional angiography.

机译：没有常规血管造影的基于磁共振成像的动静脉畸形轮廓的研究。

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OBJECTIVE: In this study, we aimed to assess the feasibility of arteriovenous malformation (AVM) delineation for gamma knife radiosurgery without conventional angiography and to correlate factors that may affect AVM delineation. METHODS: A series of 57 consecutive patients with AVMs treated with gamma knife radiosurgery from August 1994 to December 2000 were reviewed. All patients in the study had undergone pretreatment angiography. The mean AVM volume was 2.8 cm(3), with a median of 2.0 cm(3) (range, 0.04-22 cm(3)). All AVMs were delineated on the original frame-based magnetic resonance imaging (MRI) scans by a vascular neurosurgeon without the assistance of angiography and then compared with the actual AVM delineation on the basis of previously performed angiography and MRI. Univariate correlation analysis was used to determine the relationship of AVM coverage, size, diffuseness, previous embolization, and hemorrhage parameters. RESULTS: The study volume or MRI-based volume alone coincided with the actual treatment volume by a mean of 58% for diffuse and 87% for nondiffuse AVMs (P = 0.0005). At AVM volume greater than 2 cm(3), the median percentage of coinciding volume was 63% for embolized AVMs and 82% for nonembolized AVMs (P = 0.0315). Conversely, the study volume overestimated the actual treatment volume by a mean of 57% for AVMs larger than 2 cm(3) versus 25% for AVMs smaller than 2 cm(3) (P = 0.0012). In general, the percentage of the coinciding volume was inversely related to that of the excess volume, whereas both the study volume and the coinciding volume were proportionate to AVM volume at treatment. CONCLUSION: MRI-based AVM delineation without conventional angiography may be feasible only for selected patients, such as those with nondiffuse and large nonembolized AVMs.
机译：目的：在这项研究中，我们旨在评估动静脉畸形（AVM）勾画在不进行常规血管造影的情况下进行伽玛刀放射外科手术的可行性，并关联可能影响AVM勾画的因素。方法：回顾性分析了1994年8月至2000年12月接受伽马刀放射外科治疗的57例连续的AVM患者。研究中的所有患者均接受了预处理血管造影。 AVM的平均体积为2.8 cm（3），中位数为2.0 cm（3）（范围为0.04-22 cm（3））。在不借助血管造影的情况下，由血管神经外科医生在原始的基于帧的磁共振成像（MRI）扫描上勾画出所有AVM，然后根据先前进行的血管造影和MRI与实际的AVM勾画进行比较。使用单变量相关分析来确定AVM覆盖率，大小，弥散性，既往栓塞和出血参数之间的关系。结果：单独的研究量或基于MRI的量与实际治疗量相符，弥散型AVM平均为58％，非弥散型AVM平均为87％（P = 0.0005）。在AVM体积大于2 cm（3）时，栓塞AVM的重合体积百分比中位数为63％，非栓塞AVM的中值体积百分比为82％（P = 0.0315）。相反，对于大于2 cm（3）的AVM，研究量平均高估了实际治疗量的57％，而对于小于2 cm（3）的AVM，则为25％（P = 0.0012）。通常，一致的体积百分比与过量的体积成反比，而研究体积和一致的体积均与治疗时的AVM体积成比例。结论：不进行常规血管造影的基于MRI的AVM描绘仅对选定的患者是可行的，例如具有非弥散性和较大非栓塞性AVM的患者。

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