title: Time-resolved contrast-enhanced magnetic resonance angiography in the investigation of suspected intracranial dural arteriovenous fistula.
abstract: Cerebral angiography is widely regarded as the gold standard for the evaluation and diagnosis of neurovascular abnormalities. However, recent improvements in the spatial and temporal resolution of time-resolved magnetic resonance angiography (MRA) offer clinicians a non-invasive alternative to cerebral angiography. We explored the utility of this technique in an elderly female patient with a suspected intracranial dural arteriovenous fistula (dAVF). A product pulse sequence available from the scanner's manufacturer (time-resolved imaging of contrast kinetics, TRICKS; GE Healthcare, Milwaukee, WI, USA) was used with the following parameters: TR/TE 2.832/TE 1.072 ms, flip angle 25°, receiver bandwidth 31.25 kHz, 0.75 NEX, acceleration factor (ASSET) of 2, field of view 14 cm, matrix size 96 × 96, phase-encoding left-right. Twenty overlapping 8-mm-thick slices were acquired in an axial orientation, with a slice spacing of 4mm. Images were acquired at 48 time points, with a temporal resolution of 0.3s/image. We found that all intracranial venous structures enhanced synchronously. There was no evidence of arteriovenous shunting. Retrograde venous flow explained the signal abnormality seen on time-of-flight MRA. We concluded that time-resolved MRA is useful in the investigation of suspected intracranial dAVF.
authors.affiliation: Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston Massachusetts 02114, USA.
authors.forename: Benjamin D
authors.initials: BD
authors.lastname: Schanker
authors.forename: Brian P
authors.initials: BP
authors.lastname: Walcott
authors.forename: Brian V
authors.initials: BV
authors.lastname: Nahed
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Ogilvy
authors.forename: Andrew J M
authors.initials: AJ
authors.lastname: Kiruluta
authors.forename: James D
authors.initials: JD
authors.lastname: Rabinov
authors.forename: William A
authors.initials: WA
authors.lastname: Copen
mesh_terms: D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003287:Contrast Media; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis / Q000000981:diagnostic imaging*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging; D011859:Radiography; D013997:Time Factors
chemical_list: D003287:Contrast Media