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

  • Diagnostic Neuroradiology
  • Published:
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Abstract

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.

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Abbreviations

CAVM:

Cerebral arteriovenous malformations

ARUBAA:

Randomized trial of Unruptured Brain Arteriovenous malformations

DSA:

Digital subtraction angiography

D:

Dimensional

TOF:

Time of flight

MRA:

Magnetic resonance angiography

ASL:

Arterial spin labeling

UTE:

Ultrashort time echo

AV:

Arteriovenous

T:

Tesla

MRI:

Magnetic resonance imaging

NEX:

Number of excitations

MIP:

Maximum intensity projection

PLD:

Post-labeling delay

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Funding

No funding was received for this study.

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Authors and Affiliations

  1. Department of Neurosurgery, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku, Tokyo, Japan

    Nobuhiko Arai, Takenori Akiyama, Kazunari Koike, Satoshi Takahashi, Takashi Horiguchi & Kazunari Yoshida

  2. Department of Radiology, Keio University Hospital, Shinjuku, Tokyo, Japan

    Kazuhiro Fujiwara & Masahiro Jinzaki

Authors
  1. Nobuhiko Arai
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  2. Takenori Akiyama
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  3. Kazuhiro Fujiwara
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  4. Kazunari Koike
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  5. Satoshi Takahashi
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  6. Takashi Horiguchi
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  7. Masahiro Jinzaki
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  8. Kazunari Yoshida
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Correspondence to Nobuhiko Arai.

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All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Our hospital IRB deemed informed consent unnecessary for this study.

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Arai, N., Akiyama, T., Fujiwara, K. et al. Silent MRA: arterial spin labeling magnetic resonant angiography with ultra-short time echo assessing cerebral arteriovenous malformation. Neuroradiology 62, 455–461 (2020). https://doi.org/10.1007/s00234-019-02345-3

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  • DOI: https://doi.org/10.1007/s00234-019-02345-3

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