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- W2068402015 abstract "Vascular malformations (VM) are rare but confer significant morbidity. Limitations in diagnosis and treatment result from inadequate classification schema and diagnostic algorithms. The crucial distinction is between high flow and low flow lesions, as this informs both prognosis and treatment. This study is designed to assess the utility of dynamic contrast enhanced magnetic resonance imaging (dceMRI) in distinguishing high flow from low flow lesions utilizing the proposed classification scheme. A prospective database of all patients referred to the multidisciplinary Vascular Malformation team at our institution was reviewed from January 2008 to June 2010. dceMRI was obtained on each patient to determine flow characteristics and lesion extent. Additional studies were utilized as indicated. Catheter-based arteriography was performed when high flow lesions were identified with the intention of intervening, or to distinguish between high and low flow lesions when MRI was indeterminate. A classification scheme was used to evaluate patients and formulate diagnostic and therapeutic goals. We analyzed the accuracy of various diagnostic modalities in identifying high and low flow lesions. The 122 patients included 52 males (42.6%) and 70 (57.4%) females. Pain (72 patients; 59%) and swelling (88 patients; 72.1%) were the most common presenting symptoms. Diagnostic modalities employed were dceMRI (122 patients; 100%), catheter-based arteriography (18 patients; 14.8%), ultrasound (17 patients; 13.9%), and computed tomography (8 patients; 6.6%). dceMRI was diagnostic in 109 of 122 studies performed (89.3% accuracy), with only 13 arteriograms conducted to confirm indeterminate dceMRI findings. Using a classification scheme designed to identify key clinical characteristics, we were able to successfully distinguish between high flow and low flow VMs utilizing dceMRI alone in 89% of patients, minimizing the need for unnecessary invasive catheter-based procedures." @default.
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- W2068402015 date "2011-06-01" @default.
- W2068402015 modified "2023-09-27" @default.
- W2068402015 title "PS190. The Role of Magnetic Resonance Imaging and a Functional Classification Scheme in the Diagnosis and Management of Patients with Vascular Malformations" @default.
- W2068402015 doi "https://doi.org/10.1016/j.jvs.2011.03.152" @default.
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