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Vessel wall imaging and quantitative flow assessment in arteriovenous malformations: A feasibility study
Laura Stone McGuire1, Mark Rizko1, Denise Brunozzi1
1Department of Neurosurgery, The University of Illinois at Chicago, Chicago, IL, USA.
Summary
Vessel wall imaging (VWI) shows promise in identifying inflammation in cerebral arteriovenous malformations (AVMs). Enhanced venous wall enhancement on VWI may indicate a higher risk of AVM rupture.
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Background:
- Cerebral arteriovenous malformations (AVMs) have a significant annual rupture rate.
- Vessel wall inflammation is a theorized factor influencing AVM rupture risk.
- Vessel wall imaging (VWI) is a novel modality for visualizing vessel wall inflammation.
Purpose of the Study:
- To evaluate the utility of VWI in assessing cerebral arteriovenous malformations (AVMs).
- To investigate the association between VWI findings and AVM rupture status.
- To explore potential imaging biomarkers for AVM hemorrhage risk.
Main Methods:
- Retrospective review of prospectively collected data (2019-2021).
- Inclusion of adult patients with radiographically diagnosed AVMs who underwent VWI.
- Comparison of angioarchitectural features, blood flow, and VWI findings in hemorrhagic versus non-hemorrhagic AVMs.
Main Results:
- VWI successfully visualized venous walls in AVMs.
- Draining vein wall enhancement on VWI was more frequent in hemorrhagic AVMs (75%) compared to non-hemorrhagic AVMs (40%).
- Hypertension was significantly associated with AVM hemorrhage (p=0.0027).
Conclusions:
- VWI is a feasible technique for imaging AVMs.
- Increased venous wall enhancement on VWI may correlate with a higher risk of AVM hemorrhage.
- Further research is warranted to validate VWI as a biomarker for AVM rupture.
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