Time-resolved contrast-enhanced magnetic resonance angiography in the investigation of suspected intracranial dural arteriovenous fistula

• Published in: Journal of clinical neuroscience 2011-06, Vol.18 (6), p.837-839
• Main Authors: Schanker, Benjamin D, Walcott, Brian P, Nahed, Brian V, Ogilvy, Christopher S, Kiruluta, Andrew J.M, Rabinov, James D, Copen, William A
• Format: Article
• Language: English
• Subjects: Aged; Angiography; Brain - diagnostic imaging; Brain - pathology; Central nervous system vascular malformations; Central Nervous System Vascular Malformations - diagnosis; Central Nervous System Vascular Malformations - diagnostic imaging; Contrast Media; Female; Humans; Intracranial Arteriovenous Malformations - diagnosis; Intracranial Arteriovenous Malformations - diagnostic imaging; Magnetic Resonance Angiography - methods; Magnetic Resonance Imaging; MRI; Neurology; Radiography; Time Factors
• ISSN: 0967-5868; 1532-2653
• DOI: 10.1016/j.jocn.2010.12.003

Abstract Cerebral angiography is widely regarded as the gold standard for the evaluation and diagnosis of neurovascular abnormalities. However, recent improvements in the spatial and temporal resolution of time-resolved magnetic resonance angiography (MRA) offer clinicians a non-invasive alternative to cerebral angiography. We explored the utility of this technique in an elderly female patient with a suspected intracranial dural arteriovenous fistula (dAVF). A product pulse sequence available from the scanner’s manufacturer (time-resolved imaging of contrast kinetics, TRICKS; GE Healthcare, Milwaukee, WI, USA) was used with the following parameters: TR/TE 2.832/TE 1.072 ms, flip angle 25°, receiver bandwidth 31.25 kHz, 0.75 NEX, acceleration factor (ASSET) of 2, field of view 14 cm, matrix size 96 × 96, phase-encoding left-right. Twenty overlapping 8-mm-thick slices were acquired in an axial orientation, with a slice spacing of 4 mm. Images were acquired at 48 time points, with a temporal resolution of 0.3 s/image. We found that all intracranial venous structures enhanced synchronously. There was no evidence of arteriovenous shunting. Retrograde venous flow explained the signal abnormality seen on time-of-flight MRA. We concluded that time-resolved MRA is useful in the investigation of suspected intracranial dAVF.