Stracke C P, Spuentrup E, Reinacher P, Thron A, Krings T
Departments of Neuroradiology and Neurosurgery, University Hospital of the Technical University, Aachen, Germany -
Interv Neuroradiol. 2006 Sep 15;12(3):223-31. doi: 10.1177/159101990601200304. Epub 2006 Dec 13.
The decision for endovascular treatment of cranial dural AV fistulae and angiomas and their follow-up after treatment is usually based on conventional DSA. New techniques of magnetic resonance angiography (MRA) facilitate high temporal and spatial resolution images.The purpose of this study was to evaluate the applicability and clinical use of a newly developed 3D dynamic MRA protocol on a 3T scanner for neurointerventional planning and decisionmaking. Using a 3T whole body scanner, a three-dimensional dynamic contrast enhanced MRA sequence with parallel imaging, and intelligent kspace readout (Keyhole and "CENTRA" kspace filling) was added to structural MRI and time-of-flight MRA in seven patients. DSA was performed in each patient following MR examination. In all patients MRA allowed the identification and correct classification of the vascular lesion. Hemodynamic characteristics and venous architecture were clearly demonstrated. Larger feeding arteries could be identified in all cases. Smaller feeding vessels were overlooked in dynamic MRA and only depicted in conventional DSA High temporal and spatial resolution 3D MRA may correctly identify and classify fistulae and angiomas and help to reduce the number of pre- or post-interventional invasive diagnostic angiograms.
颅内硬脑膜动静脉瘘和血管瘤的血管内治疗决策及其治疗后的随访通常基于传统数字减影血管造影(DSA)。磁共振血管造影(MRA)新技术可提供高时间和空间分辨率的图像。本研究的目的是评估一种新开发的3D动态MRA方案在3T扫描仪上用于神经介入规划和决策的适用性及临床应用。使用3T全身扫描仪,在7例患者的结构MRI和时间飞跃MRA中加入了具有并行成像和智能k空间读出(钥匙孔和“CENTRA”k空间填充)的三维动态对比增强MRA序列。每位患者在MR检查后均进行了DSA检查。在所有患者中,MRA能够识别血管病变并进行正确分类。血流动力学特征和静脉结构清晰可见。在所有病例中均可识别出较大的供血动脉。动态MRA中较小的供血血管被遗漏,仅在传统DSA中显示。高时间和空间分辨率的3D MRA可正确识别和分类瘘管和血管瘤,并有助于减少介入前或介入后有创诊断血管造影的次数。