Comparing vascular morphology and hemodynamics in patients with Vein of Galen Malformations using intracranial 4D flow MRI

Vein of Galen Malformation is the most common congenital cerebrovascular malformation and patients have variable mortality risk and cognitive outcomes. Tools are needed to guide treatment decisions, so we investigated the hemodynamic underpinnings of a morphological metric used for clinical prognostication. We used 4D flow MRI to quantify flow through the venous sinus that drains the malformation, and compared this to the maximum mediolateral diameter of the same sinus. A significant positive correlation between flow and diameter was observed when controlling for prior embolization; this finding motivates continued efforts to develop hemodynamic metrics of disease severity and treatment progress.