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DSC-MR imaging using preload, intermediate (60°) flip angle and postprocessing leakage correction has gained traction as a standard methodology. Simulations suggest that DSC-MR imaging with flip angle = 30° and no preload yields relative CBV practically equivalent to the reference standard. Eighty-four patients with brain lesions were enrolled in this 3-institution study. Forty-three patients satisfied the inclusion criteria. DSC-MR imaging (3T, single-dose gadobutrol, gradient recalled-echo–EPI, TE=20–35 ms, TR=1.2–1.63 seconds) was performed twice for each patient, with flip angle = 30°–35° and no preload (P-) or provided preload (P+) for an intermediate flipangle = 60°. Compared with 60°/P+/C+, 30°/P-/C+ had closest mean standardized relative CBV, highest Lin concordance correlation coefficient, and lowest Bland-Altman bias.

In this retrospective study of 20 patients, the authors report the results of imaging-guided percutaneous superior ophthalmic vein access in dural carotid cavernous fistula treatment. Minimally invasive percutaneous imaging-guided access to the SOV can be obtained in situations in which conventional transvenousaccess to the cavernous sinus is not possible for managementof patients with dural carotid cavernous fistula. The authors conclude that direct imaging-guidedpercutaneous SOV access is a valuable and time-savingalternative route compared with direct surgical SOV access.