title: Non-contrast-enhanced 4D MR angiography with STAR spin labeling and variable flip angle sampling: a feasibility study for the assessment of Dural Arteriovenous Fistula.
abstract: BACKGROUND
  This study aimed to evaluate the feasibility of non-contrast-enhanced 4D magnetic resonance angiography (NCE 4D MRA) with signal targeting with alternative radiofrequency (STAR) spin labeling and variable flip angle (VFA) sampling in the assessment of dural arteriovenous fistula (DAVF) in the transverse sinus.
  
  
  METHODS
  Nine patients underwent NCE 4D MRA for the evaluation of DAVF in the transverse sinus at 3 T. One patient was examined twice, once before and once after the interventional treatment. All patients also underwent digital subtraction angiography (DSA) and/or contrast-enhanced magnetic resonance angiography (CEMRA). For the acquisition of NCE 4D MRA, a STAR spin tagging method was used, and a VFA sampling was applied in the data readout module instead of a constant flip angle. Two readers evaluated the NCE 4D MRA data for the diagnosis of DAVF and its type with consensus. The results were compared with those from DSA and/or CEMRA.
  
  
  RESULTS
  All patients underwent NCE 4D MRA without any difficulty. Among seven patients with patent DAVFs, all cases showed an early visualization of the transverse sinus on NCE 4D MRA. Except for one case, the type of DAVF of NCE 4D MRA was agreed with that of reference standard study. Cortical venous reflux (CVR) was demonstrated in two cases out of three patients with CVR.
  
  
  CONCLUSIONS
  NCE 4D MRA with STAR tagging and VFA sampling is technically and clinically feasible and represents a promising technique for assessment of DAVF in the transverse sinus. Further technical developments should aim at improvements of spatial and temporal coverage.
authors: Department of Radiology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea.
authors: Jinhee
authors: J
authors: Jang
authors: Peter
authors: P
authors: Schmitt
authors: Bom-yi
authors: BY
authors: Kim
authors: Hyun Seok
authors: HS
authors: Choi
authors: So-Lyung
authors: SL
authors: Jung
authors: Kook-Jin
authors: KJ
authors: Ahn
authors: Inseong
authors: I
authors: Kim
authors: Munyoung
authors: M
authors: Paek
authors: Bum-soo
authors: BS
authors: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001164:Arteriovenous Fistula / Q000473:pathology*; D055424:Cardiac-Gated Imaging Techniques / Q000379:methods*; D003287:Contrast Media; D005240:Feasibility Studies; 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 / Q000473:pathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D018401:Sample Size; D012680:Sensitivity and Specificity; D013113:Spin Labels; D054064:Transverse Sinuses / Q000473:pathology*
chemical_list: D003287:Contrast Media; D013113:Spin Labels