Sage Journals: Discover world-class research

Abstract

Aim

To classify venous malformations based on contrast-enhanced MR angiography that may serve as a basis for treatment plan.

Patients and methods

A retrospective analysis was performed in 58 patients with venous malformations who underwent contrast-enhanced MR angiography. Venous malformations were classified according to their venous drainage into: type I, isolated malformation without peripheral drainage; type II, malformation that drains into normal veins; type III, malformation that drains into dilated veins; and type IV, malformation that represents dysplastic venous ectasia. Image analysis was done by two reviewers. Intra and inter-observer agreement of both reviewers and intra-class correlation was done.

Results

The intra-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for the first reviewer (k = 0.83, 95% CI = 0.724–0.951, P = 0.001) and substantial for the second reviewer (K = 0.79, 95% CI = 0.656-0.931, P = 0.001). The inter-observer agreement of contrast-enhanced MR angiography classification of venous malformations was excellent for both reviewers at the first time (K = 0.96, 95% CI = 0.933–1.000, P = 0.001) and second time (k = 0.81, 95% CI = 0.678–0.942, P = 0.001). There was high intra-class correlation of both reviewers for single measure (ICC = 0.85, 95% CI = 0.776–0.918, P = 0.001) and for average measures (ICC = 0.96, 95% CI = 0.933–0.978, P = 0.001).

Conclusion

Contrast-enhanced MR angiography classification of venous malformations may be a useful, simple and reliable tool to accurately classify venous malformation and this topographic classification helps for better management strategy.

Keywords

Venous malformation MR angiography

Get full access to this article

View all access options for this article.

References

Lee

Baumgartner

Berlien

et al.

Diagnosis and treatment of venous malformations consensus document of the International Union of Phlebology (IUP): updated 2013. Int Angiol 2015; 34: 97–149.

Dasgupta

Patel

. Venous malformations. Semin Pediatr Surg 2014; 23: 198–202.

Judith

Ulrike

Siegmar

et al.

Current concepts in diagnosis and treatment of venous malformations. J Craniomaxillofac Surg 2014; 42: 1300–1304.

Lee

Laredo

. Venous malformation: treatment needs a bird's eye view. Phlebology 2013; 28: 62–63.

Lee

. Venous malformation and haemangioma: differential diagnosis, diagnosis, natural history and consequences. Phlebology 2013; 28: S176–S187.

Razek

. Vascular neurocutaneous disorders: neurospinal and craniofacial imaging findings. Jpn J Radiol 2014; 32: 519–528.

Richter

Braswell

. Management of venous malformations. Facial Plast Surg 2012; 28: 603–610.

Lee

Laredo

. Venous malformation: treatment needs a bird's eye view. Phlebology 2013; 28: 62–63.

Heit

Prestigiacomo

et al.

Guidelines and parameters: percutaneous sclerotherapy for the treatment of head and neck venous and lymphatic malformations. J Neurointerv Surg 2016; Epub ahead of print. DOI: 10.1136/neurintsurg-2015-012255.

10.

Aronniemi

Castrén

Lappalainen

et al.

Sclerotherapy complications of peripheral venous malformations. Phlebology 2016; 31: 712–722.

11.

Rabe

Pannier

. Sclerotherapy in venous malformation. Phlebology 2013; 28: 188–191.

12.

McCafferty

. Management of low-flow vascular malformations: clinical presentation, classification, patient selection, imaging and treatment. Cardiovasc Intervent Radiol 2015; 38: 1082–1104.

13.

Olivieri

White

Restrepo

et al.

Low-flow vascular malformation pitfalls: from clinical examination to practical imaging evaluation – Part 2, Venous malformation mimickers. AJR Am J Roentgenol 2016; 206: 952–962.

14.

Legiehn

Heran

. Venous malformations: classification, development, diagnosis, and interventional radiologic management. Radiol Clin North Am 2008; 46: 545–597.

15.

Abdel Razek

Denewer

Hegazy

et al.

Role of computed tomography angiography in the diagnosis of vascular stenosis in head and neck microvascular free flap reconstruction. Int J Oral Maxillofac Surg 2014; 43: 811–815.

16.

Razek

Huang

. Soft tissue tumors of the head and neck: imaging-based review of the WHO classification. Radiographics 2011; 31: 1923–1954.

17.

Eivazi

Fasunla

Hundt

et al.

Low flow vascular malformations of the head and neck: a study on brightness mode, color coded duplex and spectral Doppler sonography. Eur Arch Otorhinolaryngol 2011; 268: 1505–1511.

18.

Kishi

Morita

Terada

et al.

Physiological interpretations of radiographic findings on malformations of small veins: seriality of cisterns, communications to systemic veins and relationship to muscles. Phlebology 2014; 29: 9–15.

19.

Navarro

. Magnetic resonance imaging of pediatric soft-tissue vascular anomalies. Pediatr Radiol 2016; 46: 891–901.

20.

Abdel Razek

Gaballa

Elhawarey

et al.

Characterization of pediatric head and neck masses with diffusion-weighted MR imaging. Eur Radiol 2009; 19: 201–208.

21.

Razek

Elsorogy

Soliman

et al.

Dynamic susceptibility contrast perfusion MR imaging in distinguishing malignant from benign head and neck tumors: a pilot study. Eur J Radiol 2011; 77: 73–79.

22.

Krishnamurthy

Malone

Lyons

et al.

Body MR angiography in children: how we do it. Pediatr Radiol 2016; 46: 748–763.

23.

Chavhan

Babyn

John

et al.

Pediatric body MR angiography: principles, techniques, and current status in body imaging. AJR Am J Roentgenol 2015; 205: 173–184.

24.

Razek

Gaballa

Megahed

et al.

Time resolved imaging of contrast kinetics (TRICKS) MR angiography of arteriovenous malformations of head and neck. Eur J Radiol 2013; 82: 1885–1891.

25.

Romeih

Al-Sheshtawy

Salama

et al.

Comparison of contrast enhanced magnetic resonance angiography with invasive cardiac catheterization for evaluation of children with pulmonary atresia. Heart Int 2012; 7: e9–e9.

26.

Razek

Saad

Soliman

et al.

Assessment of vascular disorders of the upper extremity with contrast-enhanced magnetic resonance angiography: pictorial review. Jpn J Radiol 2010; 28: 87–94.

27.

Puig

Aref

Chigot

et al.

Classification of venous malformations in children and implications for sclerotherapy. Pediatr Radiol 2003; 33: 99–103.

28.

Jin

Lin

Chen

et al.

Craniofacial venous malformations: magnetic resonance imaging features that predict treatment outcome. J Oral Maxillofac Surg 2009; 67: 2388–2396.

29.

Goyal

Causer

Armstrong

. Venous vascular malformations in pediatric patients: comparison of results of alcohol sclerotherapy with proposed MR imaging classification. Radiology 2002; 223: 639–644.

30.

Caty

Kauffmann

Dubois

et al.

Clinical validation of semi-automated software for volumetric and dynamic contrast enhancement analysis of soft tissue venous malformations on magnetic resonance imaging examination. Eur Radiol 2014; 24: 542–551.

31.

Nishimura

Hirai

Sasao

et al.

Evaluation of dural arteriovenous fistulas with 4D contrast-enhanced MR angiography at 3T. AJNR Am J Neuroradiol 2010; 31: 80–85.

32.

Krishnamurthy

Bahouth

Muthupillai

. 4D contrast-enhanced MR angiography with the keyhole technique in children: technique and clinical applications. Radiographics 2016; 36: 523–537.

Clinical value of classification of venous malformations with contrast-enhanced MR Angiography

Abstract

Aim

Patients and methods

Results

Conclusion

Keywords

Get full access to this article

References