J Korean Soc Magn Reson Med.  2014 Sep;18(3):200-207. 10.13104/jksmrm.2014.18.3.200.

Susceptibility-Weighted MR Imaging for the Detection of Developmental Venous Anomaly: Comparison with T2 and FLAIR Imaging

• Cho SB
• Choi DS
• Ryu HG
• Shin HS
• Kim JE
• Choi HY
• Park MJ
• Choi HC
• Son S

• KMID: 1999919
• DOI: http://doi.org/10.13104/jksmrm.2014.18.3.200

Abstract

PURPOSE
We evaluated the diagnostic value of susceptibility-weighted imaging (SWI) for the detection of developmental venous anomaly (DVA).
MATERIALS AND METHODS
Retrospective review of 1068 brain MR examinations found 28 DVAs in 28 patients (2.6%) on contrast-enhanced T1-weighted images. SWI, T2, and FLAIR images of 28 patients with DVA and 28 sex- and age-matched control patients without DVA were analyzed by blinded readers on each type of sequences. All images were independently reviewed by two radiologists who were blinded to other MR imaging finding. In cases of discrepancy, two reviewers reached a consensus later. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of each MR sequence for the detection of DVA were determined. Statistical analysis was performed by using the Mcnemar test. The significance level was p < 0.05.
RESULTS
The sensitivity, specificity, PPV, and NPV of SWI for the detection of DVA were 85.7%, 92.9%, 92.3%, and 86.7%, respectively. T2 and FLAIR images showed sensitivity of 35.7% and 35.7%, specificity of 92.9% and 96.4%, PPV of 83.3% and 90.9%, and NPV of 59.1% and 60.0%, respectively. On SWI, the sensitivity and NPV for the detection of DVAs were significantly higher than those of T2 and FLAIR images (p < 0.05).
CONCLUSION
SWI was sensitive and specific for the detection of DVA.

Keyword

Cerebral developmental venous anomaly; Magnetic resonance (MR); Susceptibility-weighted imaging (SWI)

MeSH Terms

Brain
Consensus
Humans
Magnetic Resonance Imaging*
Retrospective Studies
Sensitivity and Specificity

Figure

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  Fig. 1 A 45-years-old male patient with DVA. Enhanced T1-weighted image (a) and SWI (b) show a DVA in the right frontal lobe (arrow). On T2 (c) and FLAIR (d) images, there is no definite abnormality in the right frontal lobe.

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  Fig. 2 A 48-years-old male patient with DVA. Enhanced T1 (a), SWI (b), T2 (c), and FLAIR (d) images show a DVA in the right temporal lobe (arrow). However, the lesion is less clearly demonstrated on T2 (c) and FLAIR (d) images than on SWI.

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  Fig. 3 A 77-years-old female patient with mixed angioma (DVA and cavernous angioma). Enhanced T1 (a), T2 (b), FLAIR (c), and SWI (d) images show a hemorrhagic lesion with heterogeneous signal intensity (suggestive of cavernous angioma) in the right parietal lobe (arrow). On enhanced T1-weighted image (a), there is also an enhancing DVA adjacent to the hemorrhagic lesion. However, the DVA is not demonstrated on other MR sequences.

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  Fig. 4 A 61-years-old female patient with parenchymal hemorrhage. SWI (a) shows a tubular signal void lesion in the right frontal lobe (arrow). On enhanced T1 (b), T2 (c), and FLAIR (d) images, the lesion is shown as linear signal abnormality (arrow).

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