Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582, Japan.
Neuroradiology. 2019 Sep;61(9):979-989. doi: 10.1007/s00234-019-02217-w. Epub 2019 Apr 23.
To evaluate the performance of acceleration-selective arterial spin labeling (AccASL) MR angiography in the visualization of brain arteriovenous malformations (AVMs) in comparison with digital subtraction angiography (DSA) and time-of-flight (TOF) MR angiography.
Twenty-one patients with brain AVM (mean age 31.1 ± 18.6 years; 11 males, 10 females) underwent TOF and AccASL MR angiography and DSA. Two neuroradiologists conducted an observer study for detection, nidus size, eloquence, venous drainage pattern, and Spetzler-Martin (SM) grade. The evaluations included the visualization of each AVM component with reference to DSA and assessments of contrast-to-noise ratio (CNR). The kappa statistic, repeated measures analysis of variance, Wilcoxon matched pairs test, and paired t test were used.
Both observers detected more AVMs with AccASL (95.2%, 90.5% for Observers 1 and 2) than with TOF (76.2% and 71.4%, respectively). The inter-modality agreement between AccASL and DSA was almost perfect for the eloquence, venous drainage pattern, and SM grade for Observer 1 and moderate for the venous drainage pattern and substantial for the eloquence and SM grade for Observer 2. The visualization scores were higher with AccASL than with TOF for the feeding artery (AccASL, 4.5 ± 1.0 vs. TOF, 3.9 ± 1.5, p = 0.0214), nidus (4.6 ± 1.1 vs. 3.2 ± 1.5, p = 0.0006), and draining vein (4.6 ± 1.0 vs. 2.2 ± 1.1, p < 0.0001), respectively. The CNRs in the nidus were higher in AccASL than in TOF (29.9 ± 16.7 vs. 20.8 ± 16.5, p = 0.0002), as in the draining vein (23.2 ± 13.0 vs. 12.6 ± 12.0, p = 0.0010), respectively.
AccASL better visualized brain AVMs compared with TOF and was useful for grading without the use of contrast agents.
评估加速度选择动脉自旋标记（AccASL）磁共振血管成像在脑动静脉畸形（AVM）可视化方面的性能，与数字减影血管造影（DSA）和时间飞跃（TOF）磁共振血管成像进行比较。
21 例脑 AVM 患者（平均年龄 31.1±18.6 岁；11 例男性，10 例女性）接受 TOF 和 AccASL 磁共振血管成像及 DSA 检查。两名神经放射科医生进行了观察者研究，以检测、巢大小、优势、静脉引流模式和 Spetzler-Martin（SM）分级。评估包括参考 DSA 对每个 AVM 成分的可视化，以及对比噪声比（CNR）的评估。采用卡帕统计、重复测量方差分析、Wilcoxon 匹配对检验和配对 t 检验。
两名观察者使用 AccASL 检测到的 AVM 均多于 TOF（观察者 1 和 2 分别为 95.2%和 90.5%）。AccASL 与 DSA 之间的模态间一致性对于观察者 1 的优势、静脉引流模式和 SM 分级几乎是完美的，对于观察者 2 的静脉引流模式是中度的，对于优势和 SM 分级是实质性的。与 TOF 相比，AccASL 对供血动脉（AccASL，4.5±1.0 比 TOF，3.9±1.5，p=0.0214）、巢（AccASL，4.6±1.1 比 TOF，3.2±1.5，p=0.0006）和引流静脉（AccASL，4.6±1.0 比 TOF，2.2±1.1，p<0.0001）的可视化评分更高。AccASL 中巢的 CNR 高于 TOF（29.9±16.7 比 20.8±16.5，p=0.0002），引流静脉（23.2±13.0 比 12.6±12.0，p=0.0010）。
与 TOF 相比，AccASL 更好地可视化脑 AVM，并且在不使用造影剂的情况下有助于分级。
