title: Usefulness of 3D DSA-MR fusion imaging in the pretreatment evaluation of brain arteriovenous malformations.
abstract: OBJECTIVE
  For the evaluation of patients scheduled for the treatment of brain arteriovenous malformations (AVMs), accurate anatomical information is essential. The purpose of this study was to assess the usefulness of three-dimensional (3D) digital subtraction angiography (DSA)-magnetic resonance (MR) fusion imaging for the pretreatment evaluation of AVMs.
  
  
  METHODS
  The study population consisted of 11 consecutive patients (7 males, 4 females; age 10-72 years; mean 45 years) with brain AVMs. All prospectively underwent pretreatment MR imaging (MRI), MR angiography (MRA), and two-dimensional (2D) and 3D DSA. The 3D DSA and MR images were semiautomatically fused with fusion software on a workstation. In the delineation of AVM nidus, feeder, drainer, and relationship between AVM and the adjacent brain structures, two radiologists independently evaluated MRA and MRI, three-dimensional (3D) DSA, and MRI, and 3D DSA-MR fusion images using a 4-point scoring system. The referring neurosurgeons were asked whether the information provided by 3D DSA-MR fusion images was helpful for treatment decisions.
  
  
  RESULTS
  For all four items, the delineation was significantly better with the 3D DSA/MRI or 3D DSA-MR fusion images than the MRA/MRI images. Although the delineation for the nidus, feeder, and drainer were not significantly different between the 3D DSA/MRI and 3D DSA-MR fusion images, 3D DSA-MR fusion imaging were significantly better for the relationship between AVM and the adjacent brain structures than 3D DSA/MR imaging (P = .0047). The information provided by 3D DSA-MR fusion images was helpful for treatment decisions in all cases.
  
  
  CONCLUSIONS
  3D DSA-MR fusion images are useful for the pretreatment evaluation of brain AVMs.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo, Kumamoto, Japan.
authors.forename: Satoru
authors.initials: S
authors.lastname: Ide
authors.forename: Toshinori
authors.initials: T
authors.lastname: Hirai
authors.forename: Motohiro
authors.initials: M
authors.lastname: Morioka
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kai
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Yano
authors.forename: Takayuki
authors.initials: T
authors.lastname: Kawano
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tochihara
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Shigematsu
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uetani
authors.forename: Yu
authors.initials: Y
authors.lastname: Murakami
authors.forename: Keita
authors.initials: K
authors.lastname: Watanabe
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D015901:Angiography, Digital Subtraction / Q000379:methods*; D002533:Cerebral Angiography / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D021621:Imaging, Three-Dimensional / Q000379:methods*; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis* / Q000601:surgery; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D011379:Prognosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013382:Subtraction Technique; D055815:Young Adult