Duran M, Schoenberg S O, Yuh W T C, Knopp M V, van Kaick G, Essig M
Department of Radiology, German Cancer Research Center, Im Neuenheimer Feld 280, Heidelberg, Germany.
Eur Radiol. 2002 Dec;12(12):2957-64. doi: 10.1007/s00330-002-1418-y. Epub 2002 Jun 4.
The purpose of this study was to evaluate the usefulness of a new ultrashort contrast-enhanced (CE) MR angiography (MRA) for the morphologic evaluation of cerebral arteriovenous malformations (AVMs). The method was compared with conventional X-ray digital subtraction angiography (DSA) and time-of-flight (TOF) MRA in 22 patients to assess the angioarchitecture of the malformations which is essential for treatment planning and follow-up. Two experienced MR readers independently evaluated both techniques with regard to the assessment of feeding arteries, AVM nidus, and venous drainage patterns. Contrast-enhanced MRA was able to detect all AVMs seen on DSA, whereas the TOF MRA failed in 1 patient with a very small AVM. In the assessment of the different vessel components of the AVM there was no difference for the detection and delineation of feeding arteries and the AVM. The venous drainage patterns could always be clearly delineated in the CE MRA, whereas TOF MRA could demonstrate the exact venous drainage in only 9 patients. Contrast-enhanced MRA was found to be superior to conventional TOF MRA in the assessment of the angioarchitecture of cerebral AVMs especially regarding the assessment of the venous drainage patterns. The superiority is supported by the improved vessel-to-background contrast and contrast-to-noise ratios. The major limitations of this new technique consist of a low spatial resolution at the used time resolution which can be improved by further sequence modifications. Contrast-enhanced MRA is thus an important additional imaging technique for treatment planning and follow-up of AVMs.
本研究的目的是评估一种新型超短对比增强（CE）磁共振血管造影（MRA）在脑动静脉畸形（AVM）形态学评估中的实用性。该方法与传统X线数字减影血管造影（DSA）和时间飞跃（TOF）MRA在22例患者中进行比较，以评估畸形血管结构，这对治疗计划和随访至关重要。两名经验丰富的MR阅片者独立评估这两种技术，以评估供血动脉、AVM病灶和静脉引流模式。对比增强MRA能够检测出DSA上显示的所有AVM，而1例非常小的AVM患者的TOF MRA检查失败。在AVM不同血管成分的评估中，供血动脉和AVM的检测与勾画没有差异。CE MRA总能清晰勾画出静脉引流模式，而TOF MRA仅在9例患者中能准确显示静脉引流。在脑AVM血管结构评估中，尤其是在静脉引流模式评估方面，发现对比增强MRA优于传统TOF MRA。血管与背景对比度及对比噪声比的改善支持了这种优越性。这项新技术的主要局限性在于，在所用时间分辨率下空间分辨率较低，可通过进一步的序列改进来提高。因此，对比增强MRA是AVM治疗计划和随访的一项重要的补充成像技术。
