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Brain arteriovenous malformation diagnosis: value of time-resolved contrast-enhanced MR angiography at 3.0T compared to DSA

  • Diagnostic Neuroradiology
  • Published:
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Abstract

Introduction

This study was conducted in order to evaluate the value of time-resolved contrast-enhanced magnetic resonance angiography (TR-CE-MRA) with a 3.0-T magnetic field compared to digital subtraction angiography (DSA) as the reference standard for the diagnosis of brain arteriovenous malformation (bAVM).

Methods

Nineteen patients with 19 angiographically confirmed untreated bAVM were investigated with both DSA and TR-CE-MRA for the initial diagnosis. Examinations were compared by two independent readers. Interobserver agreement and intermodality agreement with respect to nidus size, arterial feeders, and venous drainage were determined using the K statistic test. Also, the quality of the TR-CE-MRA images was evaluated.

Results

Seventeen of the 19 bAVM (89.5%) detected with DSA were diagnosed with TR-CE-MRA. Interobserver agreement for TR-CE-MRA was good for nidus size, venous drainage, and arterial feeders (K = 0.75, 95% CI 0.50–1.00; K = 0.77, 95% CI 0.54–1.00; and K = 0.80, 95% CI 0.59–1.00 respectively). Intermodality agreement was good for nidus size and venous drainage (K = 0.75, 95% CI 0.49–1.00 and K = 0.77, 95% CI 0.54–1.00, respectively) and moderate for arterial feeders (K = 0.44, 95% CI 0.17–0.70).

Conclusion

TR-CE-MRA at 3.0 T has a good sensitivity for bAVM detection and good agreement with DSA for determining nidus size and the type of venous drainage, suggesting that TR-CE-MRA is potentially a reliable tool for the diagnosis and assessment of bAVMs. However, it still suffers from low spatial resolution and vessel superposition, making differentiation of the arterial feeders of the nidus difficult at times.

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Abbreviations

2D:

Two-dimensional

3D:

Three-dimensional

4D:

Four-dimensional

ACA:

Anterior cerebral artery

bAVM:

Brain arteriovenous malformation

BG:

Basal ganglia

CENTRA:

Contrast-enhanced robust-timing angiography

CT:

Computerized tomography

DSA:

Digital subtraction angiography

Embo:

Embolization

F:

Female

FOV:

Field of view

GK:

Gamma knife

L:

Left

M:

Male

MCA:

Medium cerebral artery

MIP:

Maximum intensity projection

MRA:

Magnetic resonance angiography

MRI:

Magnetic resonance imaging

PCA:

Posterior cerebral artery

PICA:

Posterior inferior cerebellar artery

R:

Right

SENSE:

Sensitivity encoding

TR-CE-MRA:

Time-resolved contrast-enhanced magnetic resonance angiography

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Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Maison Blanche Hospital, University of Reims, 45, rue Cognacq Jay, 51100, Reims, France

    A. Machet, C. Portefaix, K. Kadziolka, G. Robin, O. Lanoix & L. Pierot

  2. CReSTIC SIC EA3804, University of Reims, Reims, France

    C. Portefaix

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  1. A. Machet
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  2. C. Portefaix
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  3. K. Kadziolka
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  4. G. Robin
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  5. O. Lanoix
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  6. L. Pierot
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Correspondence to L. Pierot.

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Machet, A., Portefaix, C., Kadziolka, K. et al. Brain arteriovenous malformation diagnosis: value of time-resolved contrast-enhanced MR angiography at 3.0T compared to DSA. Neuroradiology 54, 1099–1108 (2012). https://doi.org/10.1007/s00234-012-1024-x

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  • DOI: https://doi.org/10.1007/s00234-012-1024-x

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