Silent MRA: arterial spin labeling magnetic resonant angiography with ultra-short time echo assessing cerebral arteriovenous malformation

• Published in: Neuroradiology Vol. 62; no. 4; pp. 455 - 461
• Main Authors: Arai, Nobuhiko, Akiyama, Takenori, Fujiwara, Kazuhiro, Koike, Kazunari, Takahashi, Satoshi, Horiguchi, Takashi, Jinzaki, Masahiro, Yoshida, Kazunari
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2020; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Algorithms; Angiography; Angiography, Digital Subtraction; Cerebral blood flow; Computed tomography; Computed Tomography Angiography; Contrast Media; Diagnostic Neuroradiology; Evaluation; Female; Humans; Imaging; Imaging, Three-Dimensional; Intracranial Arteriovenous Malformations - diagnostic imaging; Labeling; Lesions; Magnetic Resonance Angiography - methods; Male; Medical imaging; Medicine; Medicine & Public Health; Middle Aged; Neurology; Neuroradiology; Neurosciences; Neurosurgery; Quality; Radiology; Spin labeling; Spin Labels; Visibility; Time echo; Magnetic resonance imaging; AV shunt disease; Arteriovenous malformation; Magnetic resonance angiography; Arterial spin labeling
• ISSN: 0028-3940; 1432-1920
• DOI: 10.1007/s00234-019-02345-3

Purpose MR angiography using the silent MR angiography algorithm (silent MRA), which combines arterial spin labeling and an ultrashort time echo, has not been used for the evaluation of cerebral arteriovenous malformations (CAVMs). We aimed to determine the usefulness of silent MRA for the evaluation of CAVMs. Methods Twenty-nine CAVMs of 28 consecutive patients diagnosed by 4D CT angiography or digital subtraction angiography, who underwent both time-of-flight (TOF) MRA and silent MRA, were enrolled. Two observers independently assessed the TOF-MRA and silent MRA images of CAVMs. Micro AVM was defined as AVM with a nidus diameter less than 10 mm. The detection rate, visualization of the components, and accuracy of Spetzler–Martin grade were evaluated with statistical software R. Results For all 29 CAVMs, 23 (79%) lesions were detected for TOF-MRA and all for silent MRA. Of 10 micro AVMs, only 4 (40%) lesions were detectable on TOF-MRA and all (100%) on silent MRA. The visibility of the nidus and drainer was significantly better for silent MRA than TOF-MRA ( p < 0.001), while there was no significant difference in the feeder between the two sequences. The accuracy rates of the Spetzler–Martin grade for the TOF and silent MRA were 38% (11/29) and 79.3% (23/29), respectively ( p < 0.001). Conclusions Silent MRA is useful for evaluating CAVM components and detecting micro AVM.