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PT  - JOURNAL ARTICLE
AU  - Hadizadeh, D.R.
AU  - Kukuk, G.M.
AU  - Steck, D.T.
AU  - Gieseke, J.
AU  - Urbach, H.
AU  - Tschampa, H.J.
AU  - Greschus, S.
AU  - Kovàcs, A.
AU  - Möhlenbruch, M.
AU  - Bostroem, A.
AU  - Schild, H.H.
AU  - Willinek, W.A.
TI  - Noninvasive Evaluation of Cerebral Arteriovenous Malformations by 4D-MRA for Preoperative Planning and Postoperative Follow-Up in 56 Patients: Comparison with DSA and Intraoperative Findings
AID  - 10.3174/ajnr.A2921
DP  - 2012 Jun 01
TA  - American Journal of Neuroradiology
PG  - 1095--1101
VI  - 33
IP  - 6
4099  - http://www.ajnr.org/content/33/6/1095.short
4100  - http://www.ajnr.org/content/33/6/1095.full
SO  - Am. J. Neuroradiol.2012 Jun 01; 33
AB  - BACKGROUND AND PURPOSE: 4D-MRA is a promising technique in the diagnosis and follow-up of cAVMs. The purpose of this study was to compare 4D-MRA in the pre- and postoperative evaluation of cAVMs with DSA or intraoperative findings as the standards of reference regarding qualitative and quantitative parameters. MATERIALS AND METHODS: Fifty-six consecutive patients with cAVMs (30 women) underwent both 4D-MRA and DSA. Preoperative 4D-MRA was excluded from analysis in 1 patient (movement artifacts). Twenty-five patients underwent surgery on cAVMs and underwent both imaging modalities pre- and postoperatively. 4D-MRA was performed with either 0.5-mol/L gadolinium-diethylene-triamine pentaacetic acid (group 1: voxel size, 1.1 × 1.1 × 1.4 mm3; 608 ms/dynamic frame; 19 patients) or 1.0-mol/L gadobutrol (group 2: voxel size, 1.1 × 1.1 × 1.1 mm3; 572 ms/dynamic frame; additional alternating view sharing; 37 patients). Two readers independently reviewed 4D-MRA and DSA regarding the Spetzler-Martin classification, arterial feeders, and postoperative residual filling. Vessel sharpness, vessel diameter, and VBC of 4D-MRA were quantified. RESULTS: Preoperative Spetzler-Martin classification 4D-MRA and DSA ratings matched in 55/55 patients (Spetzler-Martin grades: I, 12; II, 22; III, 15; IV, 5; V, 1), and 93/100 arterial feeders were correctly identified by preoperative 4D-MRA (7 additional arterial feeders identified by DSA only: group 1, 3/19; group 2, 4/36). Postoperative 4D-MRA and DSA matched in 25/25 patients (residual filling, 1/25). Vessel sharpness and diameters did not differ substantially between the 2 groups. VBC was significantly higher in group 2 (P &amp;lt; .005). CONCLUSIONS: 4D-MRA is a reliable tool that allows predicting Spetzler-Martin classification and postoperative residual filling; it hence allows substituting DSA in the pre- and postoperative evaluation of patients with cerebral AVMs. cAVMcerebral arteriovenous malformationCENTRAcontrast-enhanced timing-robust angiography4D-MRAtime-resolved MRA with subsecond temporal and high spatial resolutionFWHMfull width at half maximumNSFnephrogenic systemic fibrosisVBCvessel-to-background contrast