Intracranial arteriovenous malformation: time-resolved contrast-enhanced MR angiography with combination of parallel imaging, keyhole acquisition, and k-space sampling techniques at 1.5 T.
OBJECTIVE
To prospectively compare the agreement between digital subtraction angiography (DSA) and time-resolved magnetic resonance (MR) angiography with sensitivity encoding (SENSE) in combination with keyhole acquisition and contrast material-enhanced robust-timing angiography (CENTRA) k-space sampling techniques for the characterization of intracranial arteriovenous malformations (AVMs).


METHODS
The institutional review board approved the study; informed consent was obtained from all patients (or their parents). Twenty-eight patients (15 male, 13 female; mean age, 38.6 years; age range, 16-61 years) with 29 previously diagnosed, untreated intracranial AVMs who were referred for stereotactic gamma knife radiosurgery were evaluated. Preinterventional imaging included intraarterial DSA and time-resolved MR angiography. The time-resolved MR angiography sequence included SENSE with a 1.5-T imager and was optimized by applying keyhole acquisition and CENTRA techniques. Time-resolved MR angiograms were reviewed by two independent raters and compared with DSA images with regard to arterial feeders, nidus size, and venous drainage. kappa Statistics were applied to determine interobserver and intermodality agreement.


RESULTS
MR angiography enabled time-resolved (1.7 seconds per volume) visualization of cerebral vessels from axis to vertex at high spatial resolution (true voxel size, 1 x 1 x 2 mm). All 25 nidi detected at intraarterial DSA were visualized at time-resolved MR angiography. Intermodality agreement was excellent for arterial feeders (kappa = 0.91; 95% confidence interval [CI]: 0.786, 1.000) and venous drainage (kappa = 0.94; 95% CI: 0.814, 1.000) and was good for nidus size (kappa = 0.76; 95% CI: 0.562, 0.950).


CONCLUSIONS
The agreement (good to excellent) between time-resolved MR angiographic and DSA findings suggests that time-resolved MR angiography is a reliable tool for the characterization of intracranial AVMs with respect to arterial feeders, nidus size, and venous drainage.
Taschner
Christian A
CA
Department of Neuroradiology, Hôpital Roger Salengro, University Hospital Lille, Rue Emile Laine, F-59037 Lille Cédex, France. c.taschner@web.de
Gieseke
Jürgen
J
Le Thuc
Vianney
V
Rachdi
Henda
H
Reyns
Nicolas
N
Gauvrit
Jean-Yves
JY
Leclerc
Xavier
X
D000293:Adolescent; D000328:Adult; D015901:Angiography, Digital Subtraction; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D002538:Intracranial Arteriovenous Malformations / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008536:Meglumine; D008875:Middle Aged; D015588:Observer Variation; D009942:Organometallic Compounds
D003287:Contrast Media; D009942:Organometallic Compounds; D008536:Meglumine; C072417:gadoterate meglumine