Prediction of venous malformations with localized intravascular coagulopathy with diffusion

Venous malformations may be complicated by localized intravascular coagulopathy which is a serious condition with hematological sequel. Prediction of localized intravascular coagulopathy is mandatory for prompt anticoagulation therapy. Laboratory and routine magnetic resonance imaging can predict localized intravascular coagulopathy in venous malformations; however, the results are variable. To predict venous malformations with localized intravascular coagulopathy with diffusion-weighted magnetic resonance imaging. A retrospective analysis was performed on 55 patients (34 male, 21 female aged 14–64 years: mean 39 years) with venous malformations that underwent diffusion-weighted magnetic resonance imaging. The apparent diffusion coefficient value of venous malformations was calculated. The mean apparent diffusion coefficient value of venous malformations with localized intravascular coagulopathy (n？=？26) (1.28？±？0.18？×？10？3？mm2/s) was significantly different (P？=？0.001) from venous malformations without localized intravascular coagulopathy (n？=？29) (1.60？±？0.18？×？10？3？mm2/s). When apparent diffusion coefficient value of 1.454？×？10？3？mm2/s was used as a threshold value for the prediction of venous malformations with localized intravascular coagulopathy, the best result was obtained with an accuracy of 83.6%, sensitivity of 84.6%, specificity of 82.8%, and area under the curve of 0.895. The apparent diffusion coefficient value of venous malformations was correlated with D-dimer level (r？=？？0.59, P？=？0.006) and fibrinogen level (r？=？0.73, P？=？0.001). The apparent diffusion coefficient value is a non-invasive imaging parameter that can be used to predict venous malformations with localized intravascular coagulopathy