Fujima Noriyuki, Osanai Toshiya, Shimizu Yukie, Yoshida Atsushi, Harada Taisuke, Nakayama Naoki, Kudo Kohsuke, Houkin Kiyohiro, Shirato Hiroki
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
Department of Neurosurgery, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
J Magn Reson Imaging. 2016 Oct;44(4):834-45. doi: 10.1002/jmri.25222. Epub 2016 Mar 10.
To evaluate the utility of a vessel-selective four-dimensional (4D) magnetic resonance angiography (MRA) technique for the evaluation of intracranial arteriovenous malformations (AVMs).
Twelve AVM patients were evaluated retrospectively. Time-of-flight (TOF) MRA, nonvessel-selective 4D-MRA (NS-4D-MRA), and vessel-selective 4D-MRA (VS-4D-MRA) were performed using a 3T MR unit in all patients, and used to identify feeding arteries and draining veins and measure nidus size. The diagnostic accuracy of the three techniques was compared using digital subtraction angiography (DSA). If a multifeeder was observed, the percentage of blood flow of each feeding artery to the entire nidus was evaluated and compared to the DSA findings using the "error value," defined as the degree of overestimation of the blood flow. All imaging findings were assessed by two neuroradiologists.
In both raters, the detectability of feeding arteries by VS-4D-MRA (12 and 11 patients) was significantly higher than those of TOF-MRA (7 and 6 patients) and NS-4D-MRA (8 and 7 patients) (P < 0.016). The detectability of drainer veins by TOF-MRA (10 and 10 patients) was significantly higher than that of VS-4D-MRA (7 and 6 patients). In the percentage of the blood flow of each feed artery to the entire nidus, the DSA findings (error value; 27.1 ± 5.7) indicated overestimations of the blood flow compared to the VS-4D-MRA (error value; 7.1 ± 3.9) (P < 0.001).
VS-4D-MRA was shown to be a useful technique for the evaluation of intracranial AVMs, especially for detecting feed arteries and estimating details of the nidus structure. J. MAGN. RESON. IMAGING 2016;44:834-845.
评估血管选择性四维（4D）磁共振血管造影（MRA）技术在评估颅内动静脉畸形（AVM）中的应用价值。
对12例AVM患者进行回顾性评估。所有患者均使用3T MR设备进行时间飞跃（TOF）MRA、非血管选择性4D-MRA（NS-4D-MRA）和血管选择性4D-MRA（VS-4D-MRA）检查，以识别供血动脉和引流静脉并测量畸形瘤大小。使用数字减影血管造影（DSA）比较这三种技术的诊断准确性。如果观察到多支供血动脉，则评估每支供血动脉向整个畸形瘤供血的血流百分比，并使用“误差值”（定义为血流高估程度）与DSA结果进行比较。所有影像学检查结果均由两名神经放射科医生评估。
在两位评估者中，VS-4D-MRA对供血动脉的检出率（分别为12例和11例患者）显著高于TOF-MRA（分别为7例和6例患者）和NS-4D-MRA（分别为8例和7例患者）（P<0.016）。TOF-MRA对引流静脉的检出率（分别为10例和10例患者）显著高于VS-4D-MRA（分别为7例和6例患者）。在每支供血动脉向整个畸形瘤供血的血流百分比方面，DSA结果（误差值；27.1±5.7）显示与VS-4D-MRA相比血流存在高估（误差值；7.1±3.9）（P<0.001）。
VS-4D-MRA被证明是评估颅内AVM的一种有用技术，特别是在检测供血动脉和估计畸形瘤结构细节方面。《磁共振成像杂志》2016年；44:834 - 845。
