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Neuroradiology

, Volume 54, Issue 10, pp 1099–1108 | Cite as

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

  • A. Machet
  • C. Portefaix
  • K. Kadziolka
  • G. Robin
  • O. Lanoix
  • L. PierotEmail author
Diagnostic Neuroradiology

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.

Keywords

Brain arteriovenous malformation Imaging Time-resolved contrast-enhanced magnetic resonance angiography Digital subtraction angiography 

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

Notes

Conflict of interest

We declare that we have no conflict of interest.

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Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • A. Machet
    • 1
  • C. Portefaix
    • 1
    • 2
  • K. Kadziolka
    • 1
  • G. Robin
    • 1
  • O. Lanoix
    • 1
  • L. Pierot
    • 1
    Email author
  1. 1.Department of RadiologyMaison Blanche Hospital, University of ReimsReimsFrance
  2. 2.CReSTIC SIC EA3804University of ReimsReimsFrance

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