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A Patient-Derived Xenograft Model for Venous Malformation
Published on: June 15, 2020
Developmental venous anomalies on fetal magnetic resonance imaging: prevalence and reproducible radiological
Stephanie Libzon1,2, Moran Hausman-Kedem3,4, Nira Schneebaum-Sender3,4
1Pediatric Neurology Institute, Dana-Dwek Children's Hospital, Tel Aviv Sourasky University Medical Center (Ichilov), 6 Weizmann Street, Tel Aviv, 6423906, Israel. steph.libzon@gmail.com.
Background:
Developmental venous anomalies are the most common cerebral vascular malformations but remain underrecognized in fetuses. Accurate prenatal identification is important for diagnosis and counseling.
Objective:
This study aimed to describe the prevalence of developmental venous anomalies on fetal MRI and characterize their distinctive MRI patterns.
Materials And Methods:
A retrospective study of all fetal MRIs performed between January 2017 and June 2025. Cases with documented or suspected developmental venous anomalies were extracted, including a systematic re-evaluation of studies with susceptibility artifacts, to identify developmental venous anomalies not categorized initially as such. Two independent reviewers assessed the number, location, and drainage pattern (superficial, deep, or mixed) of developmental venous anomalies. Associated abnormalities, including varix thrombosis, parenchymal hemorrhage and volume loss, and vascular malformation, were recorded. Developmental venous anomalies with associated abnormalities or multiple developmental venous anomalies were classified as complicated developmental venous anomalies.
Results:
Among 3,932 fetuses, 18 (0.46%) had developmental venous anomalies (median gestational age 33 weeks (IQR, 32, 33); 13 males). Developmental venous anomalies were frontal in 10 (55.6%), parieto-occipital in 7 (38.9%), and parietal in 1 (5.6%); 14 (77.8%) were right-sided. Deep drainage occurred in 8/18 (44.4%), superficial in 4/18 (22.2%), and mixed in 6/18 (33.3%). Two reproducible MRI patterns were identified: the "fisherman's-rope" sign in superficial frontal developmental venous anomalies, and ventricular-wall T2 hypointensity in developmental venous anomalies with deep drainage. Eight fetuses (44.4%) had a complicated developmental venous anomaly. Multiple developmental venous anomalies (3/18, 16.7%) were associated with varix thrombosis (2/3 vs 0/15, P=0.02).
Conclusion:
Fetal developmental venous anomalies demonstrate two reproducible MRI patterns that enable confident diagnosis and help in differentiating from hemorrhage and other vascular malformations.
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