Three-dimensional contrast-enhanced MR angiography in diagnosis of cerebral arteriovenous malformation / 中华放射学杂志

ABSTRACT

Objective To evaluate the value of three-dimensional contrast-enhanced angiography (3D CE MRA) and MRI in the diagnosis and delineation of cerebral arteriovenous malformation(AVM). Methods Twenty-two cases of cerebral AVM examined by MRI and 3D CE,MRA.DSA was performed in 17 cases.A three-dimensional fast low angle shot (3D FLASH) was used for 3D CE MRA with Gd-DTPA dosage of 0.2 mmol per kilogram for body weight.The source images were subtracted from mask images and transferred to computer workstation using three-dimensional reconstruction.Results Among 22 cases, 19 showed typical AVM“flow void”signal on MR images.3D CE MRA clearly displayed the nidus,feeding artery and draining vein.All of the foci were above the cerebellum tentorium.13 located within one lobe, 3 exceeded one lobe and 3 situated in the deep of cerebrum.Feeding arteries were derived from single artery in 9 cases,and mixed supply in 10 cases.Draining veins diverted to sagittal sinus and/or sigmoid sinus in 6,deep cerebral veins in 8 and mixed in 5.In the 14 cases examined by both DSA and 3D CE MRA,3D CE MRA was superior to DSA in three-dimensional demonstration of the nidus,but inferior to DSA in demonstration of some details.3D CE MRA depicted 78.4% feeding arteries and 84.0% draining veins in addition,tiny pathologic blood vessels smaller than 1 centimeter were detected by DSA,but could not be found by 3D CE MRA and were only shown as hemorrhage lesions on MR images in 3 cases.Conclusion As a non-invasive technique,3D CE MRA combined with MRI is accurate in diagnosis and localization of cerebral AVM,and should be used as the first choice for those clinically suspected of AVM.But DSA remains needed for demonstration of details and tiny AVM.