Roya S. Saleh MD, Presenter: Nothing to Disclose

Derek Gerard Lohan MBBCh, Abstract Co-Author: Nothing to Disclose

Pablo J. Villablanca MD, Abstract Co-Author: Nothing to Disclose

Gary Ross Duckwiler MD, Abstract Co-Author: Stockholder, Concentric Medical, Inc, Mountain View, CA Scientific Advisor, Johnson & Johnson Scientific Advisor, ev3 Inc

Stephen Thomas Kee MD, Abstract Co-Author: Nothing to Disclose

J. Paul Finn MD, Abstract Co-Author: Nothing to Disclose

To evaluate intracranial arteriovenous malformations using dynamic time-resolved and high-spatial resolution MRA at 3.0 Tesla and correlate with conventional catheter angiography (CCA).

Institutional review board approval and informed consent were obtained for this HIPAA-compliant study. 20 healthy controls (6M, 18-70y/o) and 17 AVM patients (13M, 20-90y/o) underwent supra-aortic time-resolved and high spatial resolution MRA using a 32 channel 3.0 Tesla system (Siemens, Germany). Large-field-of-view coronal acquisitions extending from the root of the aorta to the vertex were performed for both techniques MRA and two radiologists performed a detailed analysis of the findings. AVM nidus size, feeding artery and draining veins were assessed using both MRA and conventional-catheter angiography when available. Arterio-venous first pass circulation times for superior sagittal sinus, bilateral common carotids and sigmoid sinuses were measured using time-resolved MRA.

96.7% (542/561) of high spatial resolution and 88% (464/527) of time-resolved MRA in patients (pts) were graded as good to excellent. MRA had 100% specificity for detecting feeding arteries and venous drainage (N=5). Nidus diameters measured by both modalities resulted in a very strong correlation (r = 0.99) with a mild over estimation by MRA (0.14 cm using Bland-Altman plot). The arterio-venous first pass circulation times derived from AVM patients were substantially different to those of controls.

Contrast enhanced MRA at 3.0T can be used for comprehensive assessment of AVM angio architecture and flow characteristics.

AVM pts are known to have an elevated risk of complications using CCA, but nonetheless require monitoring of hemodynamics. MRA at 3.0T provides a non-invasive tool for follow up evaluation of AVM pts.

Saleh, R, Lohan, D, Villablanca, P, Duckwiler, G, Kee, S, Finn, J, Evaluation of Cranio-Spinal Arteriovenous Malformations with Contrast-enhanced MR Angiography.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5007060.html