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LetterLetter

When is an Atypical DVA an AVM?

A. Mamourian and R. Wallace
American Journal of Neuroradiology February 2009, 30 (2) e24; DOI: https://doi.org/10.3174/ajnr.A1310
A. Mamourian
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We read with great interest a recent letter in the American Journal of Neuroradiology by Fushimi et al.1 They report a developmental venous anomaly (DVA) with unusual imaging findings on 3T susceptibility-weighted imaging, and they suggest that it may reflect a “relatively higher flow in the DVA…”. We wish to suggest that increased flow in a DVA would be considered an atypical feature and may, in fact, reflect that this lesion represents a mixed vascular malformation with some imaging features of both a DVA and an arteriovenous malformation (AVM). Im et al2 reported in the June issue of the Journal of Neurosurgery 15 cases of “Venous Predominant Parenchymal Arteriovenous Malformations.” The editorial in the same issue highlights the difficulty in identifying these unusual AVMs without angiography. It seems to us that this technique of susceptibility-weighted imaging at high field has the potential to differentiate a DVA from a venous predominant parenchymal arteriovenous malformation, but there is limited experience with this imaging technique in a clinical setting at this point. We believe it would be of considerable interest and importance to the patient reported by Fushimi et al1 to perform angiography because treatment may be warranted if there is evidence of AV shunting.

We would like to draw attention to this entity that is not widely appreciated in the neuroradiology community and encourage investigations into noninvasive techniques that might differentiate these similar-appearing vascular lesions.

References

  1. ↵
    Fushimi Y, Miki Y, Togashi K, et al. A developmental venous anomaly presenting atypical findings on susceptibility-weighted imaging. AJNR Am J Neuroradiol 2008;29:E56 .
    CrossRefPubMed
  2. ↵
    Im SH, Han MH, Kwon BJ, et al. Venous-predominant parenchymal arteriovenous malformation: a rare subtype with venous drainage pattern mimicking developmental venous anomaly. J Neurosurg 2008;108:1142–47
    CrossRefPubMed
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American Journal of Neuroradiology: 30 (2)
American Journal of Neuroradiology
Vol. 30, Issue 2
February 2009
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A. Mamourian, R. Wallace
When is an Atypical DVA an AVM?
American Journal of Neuroradiology Feb 2009, 30 (2) e24; DOI: 10.3174/ajnr.A1310

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When is an Atypical DVA an AVM?
A. Mamourian, R. Wallace
American Journal of Neuroradiology Feb 2009, 30 (2) e24; DOI: 10.3174/ajnr.A1310
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  • The Many Faces of Cerebral Developmental Venous Anomaly and Its Mimicks: Spectrum of Imaging Findings
    Seyed Ali Nabavizadeh, Alexander C. Mamourian, Arastoo Vossough, Laurie A. Loevner, Robert Hurst
    Journal of Neuroimaging 2016 26 5
  • A rare case of supratentorial cavernous angioma associated with arterialized developmental venous anomaly
    Matteo Martinoni, Eugenio Pozzati, Nicola Acciarri, Antonella Bacci, Andrea Cuoci, Carmelo Sturiale, Carlo Bortolotti
    Asian Journal of Neurosurgery 2019 14 03

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