The Value Of Hemodynamic Features In DSA To Assess The Ruptured Brain Arteriovenous Malformations

Objective The aim of the study was to find hemodynamic parameters associated with Brain arteriovenous malformations(bAVM) rupture on digital subtraction angiography (DSA) to establish the predictive model of bAVM rupture and help to make clinical decisions. We also had studied the correlation of hemodynamic parameters which would result in bAVM rupture with the angioarchitectures.Methods Twenty-eight patients diagnosed with bAVM who were consecutively admitted to the Department of Neurosurgery of the First Affiliated Hospital of Zhejiang University between2014.1and2015.3without treated were enrolled in the study. All patients were examined with DSA. Differences of hemodynamics and angioarchitectures between hemorrhage group and non-hemorrhage group were analysised. Predictive model of bAVM rupture was derived by Logistic analysis. And ROC curve of the model was done. At last We tried to find the correlation of hemodynamic parameters which would result in bAVM rupture with the angioarchitectures.Results Our study collected40cases of bAVM,28cases were included and18cases were excluded.17cases in the study were hemorrhage, while11cases’ manifestation were headache, defect of neurological function and epilepsy. Diameters of feeders and drainers, TTP(time to peak)of feeders and withou dilation of drainers had statistically significant correlations with bAVM rupture according to univariate logistic regression analysis. And TTP of feeders, dilation of drainers were significant independent predictors of bAVM rupture according to multivariate logistic regression analysis.Conclusions Small volume, short diameter of feeders, withou dilation of drainers had statistically significant correlations with bAVM rupture.TTP of feeders, dilation of drainers were significant independent predictors of bAVM rupture. bAVM with longer TTP of feeders and without dilation of drainers has higher risk to rupture.