RT Journal Article
SR Electronic
T1 Noninvasive Evaluation of Cerebral Arteriovenous Malformations by 4D-MRA for Preoperative Planning and Postoperative Follow-Up in 56 Patients: Comparison with DSA and Intraoperative Findings
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1095
OP 1101
DO 10.3174/ajnr.A2921
VO 33
IS 6
A1 Hadizadeh, D.R.
A1 Kukuk, G.M.
A1 Steck, D.T.
A1 Gieseke, J.
A1 Urbach, H.
A1 Tschampa, H.J.
A1 Greschus, S.
A1 Kovàcs, A.
A1 Möhlenbruch, M.
A1 Bostroem, A.
A1 Schild, H.H.
A1 Willinek, W.A.
YR 2012
UL http://www.ajnr.org/content/33/6/1095.abstract
AB BACKGROUND AND PURPOSE: 4D-MRA is a promising technique in the diagnosis and follow-up of cAVMs. The purpose of this study was to compare 4D-MRA in the pre- and postoperative evaluation of cAVMs with DSA or intraoperative findings as the standards of reference regarding qualitative and quantitative parameters. MATERIALS AND METHODS: Fifty-six consecutive patients with cAVMs (30 women) underwent both 4D-MRA and DSA. Preoperative 4D-MRA was excluded from analysis in 1 patient (movement artifacts). Twenty-five patients underwent surgery on cAVMs and underwent both imaging modalities pre- and postoperatively. 4D-MRA was performed with either 0.5-mol/L gadolinium-diethylene-triamine pentaacetic acid (group 1: voxel size, 1.1 × 1.1 × 1.4 mm3; 608 ms/dynamic frame; 19 patients) or 1.0-mol/L gadobutrol (group 2: voxel size, 1.1 × 1.1 × 1.1 mm3; 572 ms/dynamic frame; additional alternating view sharing; 37 patients). Two readers independently reviewed 4D-MRA and DSA regarding the Spetzler-Martin classification, arterial feeders, and postoperative residual filling. Vessel sharpness, vessel diameter, and VBC of 4D-MRA were quantified. RESULTS: Preoperative Spetzler-Martin classification 4D-MRA and DSA ratings matched in 55/55 patients (Spetzler-Martin grades: I, 12; II, 22; III, 15; IV, 5; V, 1), and 93/100 arterial feeders were correctly identified by preoperative 4D-MRA (7 additional arterial feeders identified by DSA only: group 1, 3/19; group 2, 4/36). Postoperative 4D-MRA and DSA matched in 25/25 patients (residual filling, 1/25). Vessel sharpness and diameters did not differ substantially between the 2 groups. VBC was significantly higher in group 2 (P < .005). CONCLUSIONS: 4D-MRA is a reliable tool that allows predicting Spetzler-Martin classification and postoperative residual filling; it hence allows substituting DSA in the pre- and postoperative evaluation of patients with cerebral AVMs. cAVMcerebral arteriovenous malformationCENTRAcontrast-enhanced timing-robust angiography4D-MRAtime-resolved MRA with subsecond temporal and high spatial resolutionFWHMfull width at half maximumNSFnephrogenic systemic fibrosisVBCvessel-to-background contrast