Intracranial Arteriovenous Malformation: Time-resolved Contrast-enhanced MR Angiography with Combination of Parallel Imaging, Keyhole Acquisition, and k-Space Sampling Techniques at 1.5 T

Purpose: To prospectively compare the agreement between digital subtraction angiography (DSA) and time-resolved magnetic resonance (MR) angiography with sensitivity encoding (SENSE) in combination with keyhole acquisition and contrast material–enhanced robust-timing angiography (CENTRA) k-space sampling techniques for the characterization of intracranial arteriovenous malformations (AVMs).

Materials and Methods: The institutional review board approved the study; informed consent was obtained from all patients (or their parents). Twenty-eight patients (15 male, 13 female; mean age, 38.6 years; age range, 16–61 years) with 29 previously diagnosed, untreated intracranial AVMs who were referred for stereotactic gamma knife radiosurgery were evaluated. Preinterventional imaging included intraarterial DSA and time-resolved MR angiography. The time-resolved MR angiography sequence included SENSE with a 1.5-T imager and was optimized by applying keyhole acquisition and CENTRA techniques. Time-resolved MR angiograms were reviewed by two independent raters and compared with DSA images with regard to arterial feeders, nidus size, and venous drainage. κ Statistics were applied to determine interobserver and intermodality agreement.

Results: MR angiography enabled time-resolved (1.7 seconds per volume) visualization of cerebral vessels from axis to vertex at high spatial resolution (true voxel size, 1 × 1 × 2 mm). All 25 nidi detected at intraarterial DSA were visualized at time-resolved MR angiography. Intermodality agreement was excellent for arterial feeders (κ = 0.91; 95% confidence interval [CI]: 0.786, 1.000) and venous drainage (κ = 0.94; 95% CI: 0.814, 1.000) and was good for nidus size (κ = 0.76; 95% CI: 0.562, 0.950).

Conclusion: The agreement (good to excellent) between time-resolved MR angiographic and DSA findings suggests that time-resolved MR angiography is a reliable tool for the characterization of intracranial AVMs with respect to arterial feeders, nidus size, and venous drainage.

Supplemental material: http://radiology.rsnajnls.org/cgi/content/full/2463070293/DC1

© RSNA, 2008

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Article History

Published in print: 2008