avm vs venous angioma

[gloriama]

My mother was "diagnosed" per mri 12 years ago as having a venous angioma. She was told this is nothing to be concerned about. About 3 years ago I was diagnosed per mri with a venous angioma as well. We both have the same neurologist and radiologist. Last week my mother had the only mri she's had in 12 years and this time the radiologist calls the vascular malformation an avm, mind you on comparison of old mri there are "no changes seen" which leads us to believe that the initial diagnoses was incorrect, subsequently she is to undergo angiogram and embolization. My question is, is an mri effective in determining an avm vs venous angioma or must one have an angiogram to be certain? I do not wish to have an angiogram if it is not neccessary but i've lost confidence in the ability to correctly diagnos vascular malformations via mri's.Also on my mri there were lesions "compatable" with cyst >2mm I was told "not to worry" about those either but I don't know now should I be reevaluated for a possible avm and "cyst"? Thank you so very much for being available to answer these questions.

[CCF-Neuro-M.D.-JT]

It's impossible to give an accurate statement regarding the correct diagnosis of the lesions in your particular case without personally reviewing your MRI. However, there are specific characteristics of a venous angioma on MRI that should be readily recognizable by a neuroradiologist. An angiogram is the definitive test to evaluate a vascular malformation (including venous angiomas and AVM). But I completely understand that you;d rather not have an angio unless you really need one. What you can do then is make an appointment with a stroke neurologist or vascular neurosurgeon at a major academic center and bring your films so they can personally review it and give their opinion. Depending on the quality of the films and the nature of the lesions, you may need further imaging studies, meaning if they're not quite sure what it is then you may need to get the angio. Here at the Cleveland Clinic, if we have a question about a vascular malformation on an MRI that was done outside, we just bring it to one of our interventional neuroradiologists or vascular neurosurgeons for their opinion. This way, we have a consensus from the experts in the field regarding the correct diagnosis and plan of management. There is a big difference between a venous angioma and AVM as your mother is finding out firsthand. So it's probably best to be safe than sorry and have your films looked at again. Good luck.