title: Evaluation of the degree of arteriovenous shunting in intracranial arteriovenous malformations using pseudo-continuous arterial spin labeling magnetic resonance imaging.
abstract: BACKGROUND
  Intracranial arteriovenous malformations (AVMs) display venous signals on arterial spin labeling (ASL) magnetic resonance (MR) imaging due to the presence of arteriovenous shunting. Our aim was to quantitatively correlate AVM signal intensity on ASL with the degree of arteriovenous shunting estimated on digital subtraction angiography (DSA) in AVMs.
  
  
  METHODS
  MR imaging including pseudo-continuous ASL at 3 T and DSA were obtained on the same day in 40 patients with intracranial AVMs. Two reviewers assessed the nidus and venous signal intensities on ASL images to determine the presence of arteriovenous shunting. Interobserver agreement on ASL between the reviewers was determined. ASL signal intensity of the AVM lesion was correlated with AVM size and the time difference between normal and AVM venous transit times measured from the DSA images.
  
  
  RESULTS
  Interobserver agreement between two reviewers for nidus and venous signal intensities was excellent (κ = 0.80 and 1.0, respectively). Interobserver agreement regarding the presence of arteriovenous shunting was perfect (κ = 1.0). AVM signal intensity showed a positive relationship with the time difference between normal and AVM venous transit times (r = 0.638, P < 0.001). AVM signal intensity also demonstrated a positive relationship with AVM size (r = 0.561, P < 0.001).
  
  
  CONCLUSIONS
  AVM signal intensity on ASL in patients with AVM correlates well with the degree of early vein opacification on DSA, which corresponds to the degree of arteriovenous shunting.
authors.affiliation: Department of Radiology, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.
authors.forename: Leonard
authors.initials: L
authors.lastname: Sunwoo
authors.forename: Chul-Ho
authors.initials: CH
authors.lastname: Sohn
authors.forename: Jong Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Kyung Sik
authors.initials: KS
authors.lastname: Yi
authors.forename: Tae Jin
authors.initials: TJ
authors.lastname: Yun
authors.forename: Seung Hong
authors.initials: SH
authors.lastname: Choi
authors.forename: Young Dae
authors.initials: YD
authors.lastname: Cho
authors.forename: Ji-Hoon
authors.initials: JH
authors.lastname: Kim
authors.forename: Sun-Won
authors.initials: SW
authors.lastname: Park
authors.forename: Moon Hee
authors.initials: MH
authors.lastname: Han
authors.forename: Sun Ha
authors.initials: SH
authors.lastname: Paek
authors.forename: Yong Hwy
authors.initials: YH
authors.lastname: Kim
authors.forename: Jin Wook
authors.initials: JW
authors.lastname: Kim
authors.forename: Hyun-Tai
authors.initials: HT
authors.lastname: Chung
authors.forename: Dong Gyu
authors.initials: DG
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods; D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000503:physiopathology*; D002550:Cerebral Veins / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000175:diagnosis* / Q000503:physiopathology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013113:Spin Labels; D055815:Young Adult
chemical_list: D013113:Spin Labels