Advanced

AJNR - American Journal of Neuroradiology

Published ahead of print on September 3, 2008
doi: 10.3174/ajnr.A1136

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Gupta, V. Articles by Jha, A.N. Search for Related Content PubMed PubMed Citation Articles by Gupta, V. Articles by Jha, A.N.

Use of CT Angiography for Anatomic Localization of Arteriovenous Malformation Nidal Components

V. Gupta^a, M. Chugh^a, B.S. Walia^b, S. Vaishya^b and A.N. Jha^b

^a Departments of Interventional Neuroradiology, Max Institute of Neurosciences, Max Superspeciality Hospital, New Delhi, India
^b Departments of Neurosurgery, Max Institute of Neurosciences, Max Superspeciality Hospital, New Delhi, India

View larger version (148K): [in this window] [in a new window]   Fig 1. MR image (T1-weighted, axial) shows scattered flow voids in left basal ganglia and internal capsule without a well-defined nidus, suggestive of a diffuse AVM (A). DSA image (left ICA injection, anteroposterior view) shows an ill-defined AVM in left basal ganglia and internal capsule (B). Venous phase shows aneurysmal dilation in draining vein along with an out-pouching (arrow, C). Left vertebral artery injection (lateral view) shows part of the AVM fed by hypertrophied thalamostriate perforator arising from posterior cerebral artery (D).

View larger version (152K): [in this window] [in a new window]   Fig 2. Microcatheter injection in the lenticulostriate artery shows patchy vascular network consistent with diffuse nature of AVM nidus (A). CTA was performed during contrast injection from microcatheter. Axial CTA image shows the nidus opacification in left basal ganglia sparing the internal capsule (arrow, B). Reconstruction with volume rendering technique (VRT) clearly shows the microcatheter and vascular network (C). Postembolization ICA angiogram shows obliteration of middle third of nidus (D). Postembolization MR (fluid-attenuated inversion recovery, axial image) showed fresh signal intensity change in the embolized portion of the basal ganglia (E). Left ICA angiogram performed 3 months after embolization shows marked shrinkage of the venous aneurysm with complete thrombosis of the pseudoaneurysm (F).

View larger version (106K): [in this window] [in a new window]   Fig 3. Left ICA angiogram after second session of embolization shows marked reduction in the size of nidus with slow opacification of the draining veins (A). CTA performed with microcatheter injection in the thalamostriate feeder showed opacification of internal capsule (arrow) medial to the glue cast (B).