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Original research
Interest of convex spherical anamorphosis in better understanding of brain AVMs' angioarchitecture
  1. Frédéric Clarençon1,
  2. Franck Maizeroi-Eugène2,
  3. Flavien Maingreaud3,
  4. Damien Bresson4,
  5. David Ayoub5,6,
  6. Nader-Antoine Sourour1,
  7. Nicolas Menjot de Champfleur7,
  8. Jacques Chiras1,
  9. Catherine Yardin8,
  10. Charbel Mounayer6
  1. 1Department of Interventional Neuroradiology, Pitié-Salpêtrière Hospital, Paris, France
  2. 2Weezin, Saint Cloud, France
  3. 3Alioscopy, Paris, France
  4. 4Department of Neurosurgery, Lariboisière University Hospital, Paris, France
  5. 5Department of Neurosurgery, Saint-Joseph University Hospital, Beyrouth, Lebanon
  6. 6Department of Neuroradiology, Limoges University Hospital, Limoges, France
  7. 7Department of Neuroradiology, Montpellier University Hospital, Montpellier, France
  8. 8Department of Histology, Cytology, Cellular Biology and Cytogenetics, Limoges University Hospital, Limoges, France
  1. Correspondence to Dr Frédéric Clarençon, Department of Neuroradiology, Pitié-Salpêtrière Hospital, 47, Bd de l'Hôpital, Paris 75013, France; fredclare5{at}


Introduction Convex spherical anamorphosis is a barrel distortion that consists of the application of a plane surface on a convex hemisphere. Applied in vascular imaging of brain arteriovenous malformations (bAVMs), this deformation may help to ‘spread’ the nidus and surrounding vessels (arteries/veins) and thus to differentiate the different components of bAVMs more accurately.

Methods The imaging data from 15 patients (8 male, 7 female; 14 supratentorial bAVMs, 1 infratentorial) were used to test the algorithm. The algorithm was applied to three-dimensional rotational angiography (3D-RA) volume rendering reconstructions in anteroposterior, lateral and oblique views and compared with regular 3D-RA and DSA. Arterial feeder and draining vein count and quality visualization of the main draining vein and intranidal aneurysms were compared between the three imaging techniques.

Results Anamorphosis was able to depict more arterial feeders than 3D-RA alone (p=0.027). There was no statistically significant difference between 6 f/s DSA and anamorphosis for arterial feeder count. No difference was observed in draining vein count between the three imaging modalities. Visualization of the precise origin of the main draining vein was considered to be good in 67% of the cases with anamorphosis versus 47% and 33% for 6 f/s DSA and 3D-RA alone, respectively. Intranidal aneurysms were accurately depicted by anamorphosis (2 cases), whereas 6 f/s DSA and 3D-RA showed doubtful images in one and two additional cases, respectively, which were finally confirmed as focal venous ectasias on supraselective injection.

Conclusions Anamorphosis can help to visualize more precisely the main draining vein origin of the bAVM and depict more accurately intranidal aneurysms.

  • Arteriovenous Malformation
  • Technology
  • Vascular Malformation

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