Abstract: Objective · To evaluate the value of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in predicting the efficacy of foam sclerotherapy and selecting sclerosants for endovascular sclerosis of venous malformations. Methods · A retrospective analysis was conducted for 56 patients with venous malformations who underwent intravascular sclerotherapy and DCE-MRI examination from January 2018 to June 2019 in Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine. All the patients were firstly treated with foam sclerotherapy. During the surgery, the surgeons determined whether to subsequently use ethanol, depending on the immediate therapeutic effect of foam sclerotherapy. Among them the 40 cases were treated with foam sclerotherapy only (foam sclerotherapy group) and the other 16 cases (ethanol group) with subsequent ethanol. The basic characteristics and DCE-MRI parameters of the two groups were compared. Logistic regression was used to analyze the risk factors of selecting different sclerosing agents, and the receiver operator characteristic curve was applied to assess the efficacy of these risk factors. Results · There were no significant differences in the gender, age, lesion location, pre-treatment volume and presence or absence of phleboliths between foam sclerotherapy group and ethanol group. The lesion classification, maximum intensity time ratio (MITR) and peak enhancement percentage showed significant differences between the two groups. Multivariate Logistic regression analysis showed that the lesion classification and MITR were two independent factors for the selection of sclerosing agents. The area under curve (AUC) of MITR was 0.947, while the AUC of lesion classification was 0.844. After the combination of these two parameters, the AUC was 0.969 with the sensitivity of 93.8% and the specificity of 90.0%. Conclusion · DCE-MRI can be helpful for clinical selection of appropriate sclerosing agents to improve the effectiveness of venous malformations treatment.

Key words: dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI), venous malformations (VMs), sclerotherapy, sclerosant