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Evaluation of the degree of arteriovenous shunting in intracranial arteriovenous malformations using pseudo-continuous arterial spin labeling magnetic resonance imaging

  • Diagnostic Neuroradiology
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Abstract

Introduction

Intracranial arteriovenous malformations (AVMs) display venous signals on arterial spin labeling (ASL) magnetic resonance (MR) imaging due to the presence of arteriovenous shunting. Our aim was to quantitatively correlate AVM signal intensity on ASL with the degree of arteriovenous shunting estimated on digital subtraction angiography (DSA) in AVMs.

Methods

MR imaging including pseudo-continuous ASL at 3 T and DSA were obtained on the same day in 40 patients with intracranial AVMs. Two reviewers assessed the nidus and venous signal intensities on ASL images to determine the presence of arteriovenous shunting. Interobserver agreement on ASL between the reviewers was determined. ASL signal intensity of the AVM lesion was correlated with AVM size and the time difference between normal and AVM venous transit times measured from the DSA images.

Results

Interobserver agreement between two reviewers for nidus and venous signal intensities was excellent (κ = 0.80 and 1.0, respectively). Interobserver agreement regarding the presence of arteriovenous shunting was perfect (κ = 1.0). AVM signal intensity showed a positive relationship with the time difference between normal and AVM venous transit times (r = 0.638, P < 0.001). AVM signal intensity also demonstrated a positive relationship with AVM size (r = 0.561, P < 0.001).

Conclusion

AVM signal intensity on ASL in patients with AVM correlates well with the degree of early vein opacification on DSA, which corresponds to the degree of arteriovenous shunting.

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Ethical standards and patient consent

We declare that all human and animal studies have been approved by our Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that due to the retrospective nature of this study, informed consent was waived.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea

    Leonard Sunwoo & Sun-Won Park

  2. Department of Radiology, Seoul National University College of Medicine, Seoul, Korea

    Leonard Sunwoo, Chul-Ho Sohn, Tae Jin Yun, Seung Hong Choi, Young Dae Cho, Ji-hoon Kim, Sun-Won Park & Moon Hee Han

  3. Department of Radiology, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, Korea

    Chul-Ho Sohn, Tae Jin Yun, Seung Hong Choi, Young Dae Cho, Ji-hoon Kim & Moon Hee Han

  4. Department of Neurosurgery, Kangdong Sacred Heart Hospital, Seoul, Korea

    Jong Young Lee

  5. Department of Radiology, Chungbuk National University Hospital, Cheongju, Korea

    Kyung Sik Yi

  6. Department of Neurosurgery, Seoul National University Hospital, Seoul, Korea

    Sun Ha Paek, Yong Hwy Kim, Jin Wook Kim, Hyun-Tai Chung & Dong Gyu Kim

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  1. Leonard Sunwoo
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  2. Chul-Ho Sohn
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  3. Jong Young Lee
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  8. Ji-hoon Kim
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  9. Sun-Won Park
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  10. Moon Hee Han
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  11. Sun Ha Paek
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  12. Yong Hwy Kim
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  13. Jin Wook Kim
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  14. Hyun-Tai Chung
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  15. Dong Gyu Kim
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Corresponding author

Correspondence to Chul-Ho Sohn.

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Sunwoo, L., Sohn, CH., Lee, J.Y. et al. Evaluation of the degree of arteriovenous shunting in intracranial arteriovenous malformations using pseudo-continuous arterial spin labeling magnetic resonance imaging. Neuroradiology 57, 775–782 (2015). https://doi.org/10.1007/s00234-015-1533-5

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  • DOI: https://doi.org/10.1007/s00234-015-1533-5

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