Prise en charge des malformations vasculaires congénitales (MVC) en 2003: Rôle de la Scintigraphie Corps entier dans la surveillance évolutive

Objective. WBBPS has established its unique role for the initial diagnosis of various CVMs as one of essential non-invasive tests. Its role has been further expanded lately for the follow-up assessment of various treatment results with substantial benefit by its practicality and cost effectiveness. The relative value of the WBBPS to the MRl for the follow-up evaluation of multisession therapy of the CVMs was assessed. Patients & Methods: Total 78 randomly selected various CVM (41 VM, 22 AVM & 15 HLM)* patients were reviewed retrospectively through the comparison study of WBBPS findings with matching MRI and/or duplex scan findings available, done as the interim treatment results assessment during/after the 215 multisession ethanol sclerotherapy. Results: Among 70 with positive findings as the treatment response, out of total 78 WBBPS, 69 were true-positive and 1 was false-positive on the comparison with MRI finding; sensitivity-95.8% and positive predictive value-98.6%. Eight with negative findings among 78 WBBPS, 5 were true-negative while 3 were false-negative; specificity-83.3% and negative predictive value-62.5%. Kappa value as an index of agreement between WBBPS and MRI was 0,687 within the range of « good »agreement (concordance) to compensate low NPV and increase its reliability. Conclusion: The WBBPS is excellent not only for the initial diagnosis of various CVMs as known, but also for the follow-up assessment of the treatment response during the multisession ethanol sclerotherapy. The WBBPS should be accepted for further role for this purpose, as practical and cost-effective test to with reasonable reliability replace most of the role of the MRI.