4D Radial Acquisition Contrast-Enhanced MR Angiography and Intracranial Arteriovenous Malformations Quickly Approaching Digital Subtraction Angiography

The current gold standard for imaging intracranial AVMs involves catheter-based techniques, namely cerebral digital subtraction angiography (DSA). However, DSA presents some procedural risks to the patient. Unfortunately, AVM patients usually undergo multiple DSA exams throughout their diagnostic an...

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Bibliographic Details
Published in:Stroke (1970) 2009-08, Vol.40 (8), p.2749-2753
Main Authors: EDDLEMAN, Christopher S, JEONG, Hyun J, HURLEY, Michael C, ZUEHLSDORFF, Sven, DABUS, Guilherme, GETCH, Christopher G, HUNT BATJER, H, BENDOK, Bernard R, CARROLL, Timothy J
Format: Article
Language:English
Subjects:
Adult
Aged
Angiography, Digital Subtraction - methods
Biological and medical sciences
Contrast Media
Female
Humans
Intracranial Arteriovenous Malformations - diagnosis
Intracranial Arteriovenous Malformations - diagnostic imaging
Intracranial Arteriovenous Malformations - surgery
Investigative techniques, diagnostic techniques (general aspects)
Magnetic Resonance Angiography - methods
Male
Medical sciences
Middle Aged
Nervous system
Neurology
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Stereotaxic Techniques
Vascular diseases and vascular malformations of the nervous system
Young Adult
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Summary:The current gold standard for imaging intracranial AVMs involves catheter-based techniques, namely cerebral digital subtraction angiography (DSA). However, DSA presents some procedural risks to the patient. Unfortunately, AVM patients usually undergo multiple DSA exams throughout their diagnostic and therapeutic course, significantly increasing their procedural risk exposure. As such, high-quality noninvasive imaging is desired. We hypothesize that 4D radial acquisition contrast-enhanced MRA approximates the vascular architecture and hemodynamics of AVMs compared to conventional angiography. Thirteen consecutive AVM patients were assessed by 4D radial acquisition contrast-enhanced MRA and DSA. The 4D rCE-MRA images were independently assessed regarding the location, nidal size, Spetzler-Martin grade, and identification of arterial feeders, drainage pattern, and any other vascular anomalies. 4D rCE-MRA correctly depicted the size, venous drainage pattern, and prominent arterial feeders in all cases. Spetzler-Martin grade was correctly determined between reviewers and between the different imaging modalities in all cases except 1. The nidus size was in good correlation between the reviewers, where r=0.99, P
ISSN:0039-2499
1524-4628
DOI:10.1161/STROKEAHA.108.546663