Three-Dimensional Dynamic MR Digital Subtraction Angiography Using Sensitivity Encoding for the Evaluation of Intracranial Arteriovenous Malformations: A Preliminary Study

Abstract

BACKGROUND AND PURPOSE: Our aim was to develop 3D dynamic MR digital subtraction angiography with high temporal resolution without sacrificing spatial resolution by using sensitivity encoding for the evaluation of cerebral arteriovenous malformations.

METHODS: Nineteen patients with 19 angiographically proven arteriovenous malformations (16 supratentorial and 3 infratentorial) were assessed by conventional catheter angiography and 3D dynamic MR digital subtraction angiography. A 3D contrast-enhanced gradient-echo sequence with sensitivity encoding based on a parallel imaging technique was performed and acquired 20 dynamic images, repeated 18 times every 1.7 seconds. Three-dimensional dynamic MR digital subtraction angiograms were analyzed independently by two radiologists in a blinded fashion with regard to arteriovenous malformation nidus and venous drainage. Conventional catheter angiography was used as reference.

RESULTS: All MR imaging examinations were assessable. Interobserver agreement was excellent for the detection of nidus and for the evaluation of nidus size (κ = 1 and 0.875, respectively) but moderate for the visualization of the venous drainage (κ = 0.56). All nidi detected on conventional catheter angiography were clearly depicted on 3D dynamic MR digital subtraction angiography. The evaluation of the size of the nidus by both techniques was similar. On 3D dynamic MR angiograms, veins were correctly analyzed in 17 of 19 arteriovenous malformations.

CONCLUSION: Our preliminary study demonstrates that 3D dynamic MR digital subtraction angiography using sensitivity encoding with a high spatial resolution is appropriate for the assessment of arteriovenous malformations.