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<meta name="DC.Title" content="Comparing Vascular Morphology and Hemodynamics in Patients with Vein of Galen Malformations Using Intracranial 4D Flow MRI" />
<meta name="DC.Identifier" content="10.3174/ajnr.A8353" />
<meta name="DC.Date" content="2024-10-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="© 2024 by American Journal of Neuroradiology" />
<meta name="DC.AccessRights" content="restricted" />
<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Vein of Galen malformation (VOGM) is the most common congenital cerebrovascular malformation, and many patients have high mortality rates and poor cognitive outcomes. Quantitative diagnostic tools are needed to improve clinical outcomes, and the purpose of this study was to characterize intracranial blood flow in VOGM using quantitative 4D flow MRI.

MATERIALS AND METHODS: A prospective study of children with VOGM was conducted by acquiring 4D flow MRI to quantify total blood inflow to the brain, flow in the pathologic falcine sinus, and flow in the superior sagittal sinus. Linear regression was used to test the relationships between these flows and age, clinical status, and the mediolateral diameter of the outflow tract of the lesion through the falcine or straight sinus diameter, which is a known morphologic prognostic metric.

RESULTS: In all 11 subjects (mean age, 22 [SD,17 ] weeks), total blood flow to the brain always exceeded normal levels (mean, 1063 [SD, 403] mL/minute). Significant correlations were observed between falcine sinus flow and the mediolateral diameter of the straight or falcine sinus, the posterior cerebral artery/MCA flow ratio and age at scanning, and superior sagittal sinus flow proximal to malformation inflow and age at scanning.

CONCLUSIONS: Using 4D flow MRI, we established the hemodynamic underpinnings of the mediolateral diameter of the straight or falcine sinus and investigated metrics representing parenchymal venous drainage that could be used to monitor the normalization of hemodynamics during embolization therapy.

ACA
:   anterior cerebral artery
BA
:   basilar artery
MD
:   mediolateral diameter of the straight or falcine sinus
NAR
:   neonatal at risk
PCA
:   posterior cerebral artery
SSS
:   superior sagittal sinus
VENC
:   encoding velocity
VOGM
:   vein of Galen malformation" />
<meta name="DC.Contributor" content="Jeffrey N. Stout" />
<meta name="DC.Contributor" content="Alfred Pokmeng See" />
<meta name="DC.Contributor" content="Julie Meadows" />
<meta name="DC.Contributor" content="Shivani D. Rangwala" />
<meta name="DC.Contributor" content="Darren B. Orbach" />
<meta name="article:published_time" content="2024-10-01" />
<meta name="article:section" content="Pediatric Neuroimaging" />
<meta name="citation_title" content="Comparing Vascular Morphology and Hemodynamics in Patients with Vein of Galen Malformations Using Intracranial 4D Flow MRI" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;Vein of Galen malformation (VOGM) is the most common congenital cerebrovascular malformation, and many patients have high mortality rates and poor cognitive outcomes. Quantitative diagnostic tools are needed to improve clinical outcomes, and the purpose of this study was to characterize intracranial blood flow in VOGM using quantitative 4D flow MRI.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;A prospective study of children with VOGM was conducted by acquiring 4D flow MRI to quantify total blood inflow to the brain, flow in the pathologic falcine sinus, and flow in the superior sagittal sinus. Linear regression was used to test the relationships between these flows and age, clinical status, and the mediolateral diameter of the outflow tract of the lesion through the falcine or straight sinus diameter, which is a known morphologic prognostic metric.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In all 11 subjects (mean age, 22 [SD,17 ] weeks), total blood flow to the brain always exceeded normal levels (mean, 1063 [SD, 403] mL/minute). Significant correlations were observed between falcine sinus flow and the mediolateral diameter of the straight or falcine sinus, the posterior cerebral artery/MCA flow ratio and age at scanning, and superior sagittal sinus flow proximal to malformation inflow and age at scanning.&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Using 4D flow MRI, we established the hemodynamic underpinnings of the mediolateral diameter of the straight or falcine sinus and investigated metrics representing parenchymal venous drainage that could be used to monitor the normalization of hemodynamics during embolization therapy.&lt;/p&gt;" />
<meta name="citation_journal_title" content="American Journal of Neuroradiology" />
<meta name="citation_publisher" content="American Journal of Neuroradiology" />
<meta name="citation_publication_date" content="2024/10/01" />
<meta name="citation_mjid" content="ajnr;45/10/1586" />
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<meta name="twitter:title" content="Comparing Vascular Morphology and Hemodynamics in Patients with Vein of Galen Malformations Using Intracranial 4D Flow MRI" />
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<meta name="twitter:image" content="http://ajnr-stage2.stage.highwire.org/sites/default/files/highwire/ajnr/45/10.cover-source.jpg" />
<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Vein of Galen malformation (VOGM) is the most common congenital cerebrovascular malformation, and many patients have high mortality rates and poor cognitive outcomes. Quantitative diagnostic tools are needed to improve clinical outcomes, and the purpose of this study was to characterize intracranial blood flow in VOGM using quantitative 4D flow MRI.

MATERIALS AND METHODS: A prospective study of children with VOGM was conducted by acquiring 4D flow MRI to quantify total blood inflow to the brain, flow in the pathologic falcine sinus, and flow in the superior sagittal sinus. Linear regression was used to test the relationships between these flows and age, clinical status, and the mediolateral diameter of the outflow tract of the lesion through the falcine or straight sinus diameter, which is a known morphologic prognostic metric.

RESULTS: In all 11 subjects (mean age, 22 [SD,17 ] weeks), total blood flow to the brain always exceeded normal levels (mean, 1063 [SD, 403] mL/minute). Significant correlations were observed between falcine sinus flow and the mediolateral diameter of the straight or falcine sinus, the posterior cerebral artery/MCA flow ratio and age at scanning, and superior sagittal sinus flow proximal to malformation inflow and age at scanning.

CONCLUSIONS: Using 4D flow MRI, we established the hemodynamic underpinnings of the mediolateral diameter of the straight or falcine sinus and investigated metrics representing parenchymal venous drainage that could be used to monitor the normalization of hemodynamics during embolization therapy.

ACA
:   anterior cerebral artery
BA
:   basilar artery
MD
:   mediolateral diameter of the straight or falcine sinus
NAR
:   neonatal at risk
PCA
:   posterior cerebral artery
SSS
:   superior sagittal sinus
VENC
:   encoding velocity
VOGM
:   vein of Galen malformation" />
<meta name="og-title" property="og:title" content="Comparing Vascular Morphology and Hemodynamics in Patients with Vein of Galen Malformations Using Intracranial 4D Flow MRI" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/45/10/1586" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Vein of Galen malformation (VOGM) is the most common congenital cerebrovascular malformation, and many patients have high mortality rates and poor cognitive outcomes. Quantitative diagnostic tools are needed to improve clinical outcomes, and the purpose of this study was to characterize intracranial blood flow in VOGM using quantitative 4D flow MRI.

MATERIALS AND METHODS: A prospective study of children with VOGM was conducted by acquiring 4D flow MRI to quantify total blood inflow to the brain, flow in the pathologic falcine sinus, and flow in the superior sagittal sinus. Linear regression was used to test the relationships between these flows and age, clinical status, and the mediolateral diameter of the outflow tract of the lesion through the falcine or straight sinus diameter, which is a known morphologic prognostic metric.

RESULTS: In all 11 subjects (mean age, 22 [SD,17 ] weeks), total blood flow to the brain always exceeded normal levels (mean, 1063 [SD, 403] mL/minute). Significant correlations were observed between falcine sinus flow and the mediolateral diameter of the straight or falcine sinus, the posterior cerebral artery/MCA flow ratio and age at scanning, and superior sagittal sinus flow proximal to malformation inflow and age at scanning.

CONCLUSIONS: Using 4D flow MRI, we established the hemodynamic underpinnings of the mediolateral diameter of the straight or falcine sinus and investigated metrics representing parenchymal venous drainage that could be used to monitor the normalization of hemodynamics during embolization therapy.

ACA
:   anterior cerebral artery
BA
:   basilar artery
MD
:   mediolateral diameter of the straight or falcine sinus
NAR
:   neonatal at risk
PCA
:   posterior cerebral artery
SSS
:   superior sagittal sinus
VENC
:   encoding velocity
VOGM
:   vein of Galen malformation" />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node110793--5" data-node-nid="110793" id="top-node-110793--61301046626" data-pisa="ajnr;45/10/1586" data-pisa-master="ajnr;ajnr.A8353" data-apath="/ajnr/45/10/1586.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">Pediatric Neuroimaging</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Comparing Vascular Morphology and Hemodynamics in Patients with Vein of Galen Malformations Using Intracranial 4D Flow MRI</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">Jeffrey N. Stout</span>, <span class="highwire-citation-author" data-delta="1">Alfred Pokmeng See</span>, <span class="highwire-citation-author" data-delta="2">Julie Meadows</span>, <span class="highwire-citation-author" data-delta="3">Shivani D. Rangwala</span> and <span class="highwire-citation-author" data-delta="4">Darren B. Orbach</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2024,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1586-1592; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A8353 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-110793--61301046626" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">Jeffrey N. Stout </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Cerebrovascular Surgery and Interventions Center (J.N.S., A.P.S., J.M., D.B.O.), Boston Children’s Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Jeffrey%2BN.%2BStout%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Stout%20JN&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJeffrey%2BN.%2BStout%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7342-3018" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Jeffrey N. Stout</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">Alfred Pokmeng See </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Cerebrovascular Surgery and Interventions Center (J.N.S., A.P.S., J.M., D.B.O.), Boston Children’s Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Alfred%2BPokmeng%2BSee%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=See%20AP&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AAlfred%2BPokmeng%2BSee%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-3634-4692" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Alfred Pokmeng See</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">Julie Meadows </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Cerebrovascular Surgery and Interventions Center (J.N.S., A.P.S., J.M., D.B.O.), Boston Children’s Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Julie%2BMeadows%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Meadows%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AJulie%2BMeadows%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">Shivani D. Rangwala </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of Neurosurgery (S.D.R.), Keck School of Medicine, University of Southern California, Los Angeles, California</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Shivani%2BD.%2BRangwala%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Rangwala%20SD&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AShivani%2BD.%2BRangwala%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-7378-2600" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Shivani D. Rangwala</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">Darren B. Orbach </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Cerebrovascular Surgery and Interventions Center (J.N.S., A.P.S., J.M., D.B.O.), Boston Children’s Hospital, Boston, Massachusetts</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=Darren%2BB.%2BOrbach%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Orbach%20DB&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3ADarren%2BB.%2BOrbach%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-1793-3398" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for Darren B. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 45</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 10 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Oct 2024 </div></div>
      
      
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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Oct 2024, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">45 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(10) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1586-1592; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A8353 </span></div>
  
  
  
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