title: Comparison of MR angiography and conventional angiography in the investigation of intracranial arteriovenous malformations and aneurysms in children.
abstract: BACKGROUND
  Magnetic resonance angiography (MRA) is an attractive alternative to conventional catheter angiography (CCA) in children, especially for the detection of intracranial arteriovenous malformations (AVMs) or aneurysms in the out-of-hours setting, because it has fewer risks and complications. OBJECTIVE. To compare MRA with CCA for the detection of intracranial AVMs, aneurysms and arterial anatomy in children.
  
  
  METHODS
  Retrospective blinded review of MRAs and CCAs by two independent paediatric radiologists, in a group of 19 children already diagnosed with AVMs, aneurysms and subarachnoid haemorrhage (SAH) and who had undergone both imaging techniques.
  
  
  RESULTS
  Abnormalities were identified on MRA in 15 of 19 patients and by CCA in 11 of 19 patients. MRA showed one aneurysm, nine AVMs, three haemorrhages and two indeterminate lesions. CCA showed nine AVMs and two indeterminate lesions. The two modalities showed excellent correlation in the detection of AVMs in nine patients. Vascular supply to the AVMs correlated well in four cases. There was complete disagreement in the determination of vessel supply in one case, and in two cases CCA showed additional vessel supply compared to MRA, while in two further cases MRA showed an additional vessel supply compared to CCA. CCA was superior to MRA in demonstrating arterial anatomy, except with regard to the anterior and posterior communicating arteries where MRA was superior.
  
  
  CONCLUSIONS
  The high sensitivity of MRA in the detection of AVMs when compared to CCA and the low incidence of aneurysms support the use of MRA as the initial imaging modality when intracranial haemorrhage is diagnosed on CT, especially in the out-of-hours setting.
authors.affiliation: Department of Paediatric Radiology, Royal Children's Hospital, Melbourne, Australia.
authors.forename: Stephen
authors.initials: S
authors.lastname: Fasulakis
authors.forename: Savvas
authors.initials: S
authors.lastname: Andronikou
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000000981:diagnostic imaging* / Q000503:physiopathology; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008297:Male; D012016:Reference Values; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index