Brain arteriovenous malformation diagnosis: value of time-resolved contrast-enhanced MR angiography at 3.0T compared to DSA
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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).
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.
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).
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.
KeywordsBrain arteriovenous malformation Imaging Time-resolved contrast-enhanced magnetic resonance angiography Digital subtraction angiography
Anterior cerebral artery
Brain arteriovenous malformation
Contrast-enhanced robust-timing angiography
Digital subtraction angiography
Field of view
Medium cerebral artery
Maximum intensity projection
Magnetic resonance angiography
Magnetic resonance imaging
Posterior cerebral artery
Posterior inferior cerebellar artery
Time-resolved contrast-enhanced magnetic resonance angiography
Conflict of interest
We declare that we have no conflict of interest.