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Journal of Pediatric Neurology 2022; 20(02): 103-108
DOI: 10.1055/s-0041-1736554
Original Article

Diagnostic Accuracy of SWAN in the Diagnosis of Low-Flow Brain Vascular Malformations in Childhood

Nazlı Gülsüm Akyel 
1   Department of Pediatric Radiology, Sanliurfa Training and Research Hospital, Şanliurfa, Turkey
,
Ayşe Gül Alımlı
2   Department of Pediatric Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
,
Mesut Sivri
3   Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
,
Havva Akmaz Ünlü
3   Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
,
Mehmet Tiftik
3   Department of Radiology, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
› Author Affiliations Funding None.
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Abstract

Purpose The main objective of this study is to demonstrate the diagnostic accuracy of susceptibility-weighted angiography (SWAN) in the diagnosis of slow-flow cerebral vascular malformations, especially developmental venous anomaly (DVA). We also aimed to determine the prevalence of DVAs identified by SWAN at 1.5 T.

Methods We retrospectively evaluated 1,760 axial SWAN images for the diagnosis of low-flow vascular anomaly. Among them were 305 patients who underwent contrast-enhanced examination due to different indications. Postcontrast images were analyzed by different radiologists who were blinded to patients. The presence of DVA and other features such as location, length, depth, and direction of drainage vein was evaluated.

Results Twenty-six patients with DVA had both SWAN and postcontrast images. There were four false-negative patients with SWAN. The sensitivity of the SWAN sequence was 84.6%. In addition, totally 77 DVA (4.36%), 2 capillary telangiectasia (0.11%), and 2 cavernous malformations (0.11%) were detected in 1,760 patients.

Conclusion SWAN is an effective method for the diagnosis of developmental venous anomalies and other low-flow cerebral vascular malformations. Especially in the pediatric age, susceptibility-weighted imaging sequences are useful to limit contrast use.

Keywords

developmental venous anomaly - cavernous angiomas - capillary telangiectasia - susceptibility-weighted angiography - susceptibility-weighted imaging - magnetic resonance imaging

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


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Publication History

Received: 14 April 2021

Accepted: 16 September 2021

Article published online:
25 October 2021

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