title: Susceptibility-weighted angiography for the detection of high-flow intracranial vascular lesions: preliminary study.
abstract: OBJECTIVE
  Susceptibility-weighted magnetic resonance imaging (MRI) sequences may demonstrate various signal intensities of draining veins in cases of high-flow vascular malformation (HFVM), including arteriovenous malformation (AVM) and dural arteriovenous fistula (dAVF). Our objective was to evaluate susceptibility-weighted angiography (SWAN) for the detection of HFVM.
  
  
  METHODS
  Fifty-eight consecutive patients with a suspected intracranial vascular malformation were explored with SWAN and post-contrast MRI sequences at 3 T. The diagnosis of slow-flow vascular malformation (SFVM), including developmental venous anomaly (DVA) or brain capillary telangiectasia (BCT), was based on MRI. Patients with suspected HFVM underwent digital subtraction angiography (DSA). SWAN images were analysed by three blinded readers according to a three-point scale of the venous signal.
  
  
  RESULTS
  Thirty-one patients presented 35 SFVM (26 DVA and 9 BCT) that systematically appeared hypointense on SWAN images. In patients with atypical MRI findings, DSA revealed one patient with an atypical DVA and 26 patients with HFVM (22 AVM and 4 dAVF). SWAN revealed at least one venous hyperintensity in all patients with HFVM. Agreement between readers was excellent.
  
  
  CONCLUSIONS
  SWAN appears reliable for characterising blood flow dynamics in brain veins. In clinical practice, SWAN can routinely rule out HFVM in patients with atypical brain veins.
authors.affiliation: Department of Radiology, Hôpital Saint Joseph, Paris, France. jeromehodel@hotmail.com
authors.forename: Jérôme
authors.initials: J
authors.lastname: Hodel
authors.forename: Raphaël
authors.initials: R
authors.lastname: Blanc
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rodallec
authors.forename: Antoine
authors.initials: A
authors.lastname: Guillonnet
authors.forename: Sophie
authors.initials: S
authors.lastname: Gerber
authors.forename: Silvia
authors.initials: S
authors.lastname: Pistocchi
authors.forename: Rémi
authors.initials: R
authors.lastname: Sitta
authors.forename: Cécile
authors.initials: C
authors.lastname: Rabrait
authors.forename: Mathieu
authors.initials: M
authors.lastname: Zuber
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Pruvo
authors.forename: Marc
authors.initials: M
authors.lastname: Zins
authors.forename: Xavier
authors.initials: X
authors.lastname: Leclerc
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D002538:Intracranial Arteriovenous Malformations / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult