DIAGNOSTIC NEURORADIOLOGY The angioarchitectural factors of the cerebral developmental venous anomaly; can they be the causes of concurrent sporadic cavernous malformation? Yoo Jin Hong & Tae-Sub Chung & Sang Hyun Suh & Chul Hwan Park & Geetanjali Tomar & Kwon Duk Seo & Keung Sik Kim & In Kook Park Received: 3 August 2009 / Accepted: 18 November 2009 / Published online: 21 January 2010 # Springer-Verlag 2010 Abstract Introduction The aim of this paper was to evaluate the angioarchitectural factors that can induce concurrent cav- ernous malformation (CM) in the territory of developmental venous anomaly (DVA). Methods From January 2006 to December 2007, 21 patients with 23 CMs in the territory of DVA were retrospectively analyzed (M; F=12; 9, mean age=53.3). Gadovist®-enhanced three-dimensional spoiled gradient- echo images on a 3 T magnetic resonance (MR) scanner were used. We investigated the presence of angioarchitec- tural factors: factor 1, the angulated course of curved medullary or draining vein in the distal portion of CM; factor 2, narrowing of distal draining vein; factor 3, severe medullary venous tortuosity. These were also analyzed for control group of 23 subjects (M; F=11; 12, mean age=46). Results Factor 1 was demonstrated in 22 cases (97%) and the CM occurred in a position of 90° or less of an abrupt angulated medullary or draining vein in 15 cases (65%) of the study group. Factor 2 was found in 13 cases (57%) with the diameter reduction of 50% or more in five cases. The mean ratio of diameter reduction was 0.53. Factor 3 was found in 17 cases (74%). Analyzing the independent factors, the p values for factors 1 and 3 were <.05, i.e., statistically significant. If combination of more than two factors was present, the p values for all the combinations were <0.05, i.e., statistically significant. Conclusion Anatomical angioarchitectural factors might be the key factors in causing concurrent sporadic CM within the territory of DVA by causing disturbance of blood flow. Keywords Cavernous malformation . Developmental venous anomaly . Flow disturbance . Angioarchitectural factor Abbreviations CM cavernous malformation DVA developmental venous anomaly SPGR spoiled gradient-echo MPRs multiplanar reconstructions Introduction Developmental venous anomaly (DVA) is the most fre- quently found cerebral vascular anomaly. It is usually discovered incidentally on enhanced CT or brain magnetic resonance imaging (MRI) with a reported incidence of 0.05-2.56% in the general population [1–4]. The main suggested etiology for the formation of DVAs is an embryologic accident that results in either arrested formation or thrombosis of the developing venous drainage of the specific region. This is followed by a secondary Y. J. Hong : T.-S. Chung (*) : S. H. Suh : C. H. Park : G. Tomar : K. S. Kim Department of Radiology, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eunjuro, Gangnam-gu, Seoul, South Korea, 135-270 e-mail: tschung@yuhs.ac K. D. Seo Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea I. K. Park Department of Life Sciences, Dongguk University, Gyungju, South Korea Neuroradiology (2010) 52:883–891 DOI 10.1007/s00234-009-0640-6