Laura Oleaga, Presenter: Nothing to Disclose

Dalal Shamsher, Abstract Co-Author: Nothing to Disclose

John Weigele, Abstract Co-Author: Nothing to Disclose

Robert W. Hurst MD, Abstract Co-Author: Nothing to Disclose

Abram Voorhees, Abstract Co-Author: Nothing to Disclose

John Lee, Abstract Co-Author: Nothing to Disclose

Elias Rafic Melhem MD, PhD, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

et al, Abstract Co-Author: Nothing to Disclose

To assess the utility of 3D time resolved gadolinium enhanced MR angiography in the evaluation and grading cerebral arteriovenous malformations (AVMS)

Seven patients with known AVMs were studied using a time resolved 3D gadolinium enhanced MR angiographic technique, which incorporates 2 dimensional Generalized Autocalibrating Partially Parallel Acquisitions (GRAPPA). We assessed the three components of the AVMs: nidus, feeding arteries and draining veins. AVMs were graded according to the modified Spetzler-Martin grading system. All patients were examined on a 3.0 Tesla system (Trio. Siemens Medical Systems, Erlangen, Germany), with a multi-channel phased-array coil. 3D gadolinium enhanced images were obtained in the sagittal plane with imaging times of 1.7 seconds/frame. 20 frames were acquired,to assess the time course in the feeding arteries and draining veins using 20cc of gadolinium DTPA at a flow rate of 5ml/s. Time resolved maximal intensity projection (MIP) images were generated in the three orthogonal planes from the source images. Intraarterial digital subtraction angiography (DSA) was used as the gold standard.

MRI correctly graded the AVM’s in three cases as grade I, two cases as grade II, one case grade III, and one case as grade IV acording to the Spetzler-Martin grading system. The location, involvement of eloquent areas, arterial feeding and venous drainage was correctly depicted with the dynamic angiographic technique, demonstrating deep venous drainage in two of the cases and involvement of an eloquent area in one case. In all cases the time-resolved image frames allowed the adequate separation of the feeding arteries from the draining veins while maintaing high spatial resolution.

3D time resolved MR angiography showed the configuration of the AVMs in all the cases, it provided high spatial resolution images in sagittal, axial and coronal planes and afforded good dynamic information with good artery-vein separation.

3D time resolved MR angiography provides good spatial and time resolution images. This technique can be a substitute for DSA imaging in the pre-treatment assessment of AVMs.

Oleaga, L, Shamsher, D, Weigele, J, Hurst, R, Voorhees, A, Lee, J, Melhem, E, et al, , et al, , Clinical Efficacy of Time Resolved 3D Gadolinium-enhanced MR Angiography in the Assessment and Grading of Cerebral Arteriovenous Malformations.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5001814.html