Clinical Neuroradiology

, Volume 23, Issue 2, pp 97–101 | Cite as

Intranidal Signal Distribution in Post-Contrast Time-of-Flight MRA is Associated with Rupture Risk Factors in Arteriovenous Malformations

  • N. D. ForkertEmail author
  • J. Fiehler
  • M. Schönfeld
  • J. Sedlacik
  • J. Regelsberger
  • H. Handels
  • T. Illies
Original Article



To evaluate if arteriovenous malformations (AVMs) that are associated with a high rupture risk (HRR) are represented by different intranidal Time-of-Flight (TOF) magnetic resonance angiography intensity distributions compared to those with presumably low rupture risk (LRR).


Fifty post-contrast TOF datasets of patients with an AVM were analyzed in this study. The patients were classified to the HRR group in case of a deep location, presence of exclusive deep venous drainage, previous hemorrhagic event or a combination thereof. For each TOF dataset, the AVM nidus was semi-automatically delineated and used for histogram extraction. Each histogram was analyzed by calculating the skewness, kurtosis, mean and median intensity and full-width-half-maximum. Statistical analysis was performed using parameter-wise two-sided t-tests of the parameters between the two groups.


Based on morphological analysis, 21 patients were classified to the HRR and 29 patients to the LRR group. Statistical analysis revealed that TOF intensity distributions of HRR AVMs exhibit a significant higher skewness (p = 0.0005) parameter compared to LRR AVMs. Contrary to these findings, no significant differences were found for the other parameters evaluated.


Intranidal flow heterogeneity, for example, caused by turbulent flow conditions, may play an important role for risk of a hemorrhage. An analysis of post-contrast TOF intensities within the nidus of an AVM may offer simple and valuable information for clinical risk estimation of AVMs and needs to be tested prospectively.


Intracranial arteriovenous malformations Hemodynamics Cerebral hemorrhage Magnetic resonance angiography 


Conflict of Interest

The authors declare that there is no actual or potential conflict of interest in relation to this article.


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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • N. D. Forkert
    • 1
    Email author
  • J. Fiehler
    • 2
  • M. Schönfeld
    • 2
  • J. Sedlacik
    • 2
  • J. Regelsberger
    • 3
  • H. Handels
    • 4
  • T. Illies
    • 2
  1. 1.Department of Computational NeuroscienceUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Department of Diagnostic and Interventional NeuroradiologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  3. 3.Department of NeurosurgeryUniversity Medical Center Hamburg-EppendorfHamburgGermany
  4. 4.Institute of Medical InformaticsUniversity of LübeckLübeckGermany

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