Imaging of arteriovenous malformation following stereotactic radiosurgery

• Published in: Pediatric radiology Vol. 27; no. 4; pp. 299 - 304
• Main Authors: TRANCHIDA, J. V, MEHALL, C. J, SLOVIS, T. L, LIS-PLANELLS, M
• Format: Journal Article
• Language: English
• Published: Berlin Springer 01.04.1997; Springer Nature B.V
• Subjects: Biological and medical sciences; Brain - pathology; Cerebral Angiography; Child; Female; Follow-Up Studies; Humans; Intracranial Arteriovenous Malformations - diagnosis; Intracranial Arteriovenous Malformations - surgery; Investigative techniques, diagnostic techniques (general aspects); Magnetic Resonance Imaging; Medical sciences; Nervous system; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Radiosurgery; Time Factors; Tomography, X-Ray Computed; Human; Postoperative; Intracranial; Nervous system diseases; Radiodiagnosis; Radiosurgery; Cardiovascular disease; Stereotaxia; Congenital disease; Nuclear magnetic resonance imaging; Cerebral disorder; Vascular disease; Case study; Treatment; Surgery; Central nervous system disease; Medical imagery; Computerized axial tomography; Child; Cerebrovascular disease; Arteriovenous malformation
• ISSN: 0301-0449; 1432-1998
• DOI: 10.1007/s002470050133

Stereotactic radiosurgery allows for a high dose of focused radiation to be delivered to a small lesion such as an arteriovenous malformation (AVM). The clinical change and brain response over time to this localized high-dose radiation can be quite striking. The objective of this study to describe and analyse the imaging changes following radiotherapy for AVMs. The clinical presentation and the imaging changes following radiotherapy in two patients were studied over the course of 1-2 years. The imaging findings include diffuse low attenuation and contrast enhancement on CT. High-signal lesions were apparent on T2-weighted MR images with prominent contrast enhancement on T1-weighted images. Ring enhancement occurred over time. While new changes appeared over 12 months, these changes diminished during the second year. Radiotherapy induces inflammatory changes that are generally reversible but can lead to parenchymal destruction. These imaging changes are often nonspecific and therefore must be interpreted in light of clinical symptomatology and the time course since treatment. These patients should receive routine MR imaging within 3 months after radiosurgery with follow-up imaging at 6, 12, and 18 months.