Advanced

AJNR - American Journal of Neuroradiology

Published ahead of print on March 13, 2008
doi: 10.3174/ajnr.A0947

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map 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 Saleh, R.S. Articles by Finn, J.P. Search for Related Content PubMed PubMed Citation Articles by Saleh, R.S. Articles by Finn, J.P.

Assessment of Craniospinal Arteriovenous Malformations at 3T with Highly Temporally and Highly Spatially Resolved Contrast-Enhanced MR Angiography

R.S. Saleh^a, D.G. Lohan^a, J.P. Villablanca^b, G. Duckwiler^c, S.T. Kee^d and J.P. Finn^a

^a Division of Diagnostic Cardiovascular Imaging, Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif
^b Division of Neuroradiology, Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif
^c Division of Neuro-Interventional Radiology, Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif
^d Division of Interventional Radiology, Department of Radiology, David Geffen School of Medicine at the University of California, Los Angeles, Los Angeles, Calif

View larger version (57K): [in this window] [in a new window]   Fig 1. A and B, Coronal VR projections from CE-MRA (voxel volume, 0.8 x 0.7 x 0.8 mm3) in a 22-year-old woman with a history of intraspinal hemorrhage and cervical laminectomy. Arterial (A) and venous (B) phase images show a diffuse serpiginous cervical C2–C3 AVM. Note the feeding vessel derived from the right vertebral artery (arrows). Venous drainage was through the paravertebral venous plexus and the occipital sinus (arrowheads). C, Time-resolved images with 1.5-second temporal resolution and 1.2 x 1 mm in-plane resolution show enhancement of the AVM via the right vertebral artery (arrows) and subsequent venous drainage. D, A phase-by-phase comparison with CCA is presented. MRA and CCA examinations were performed on the same day, before radiosurgery.

View larger version (55K): [in this window] [in a new window]   Fig 2. A, MIP from 3D high-spatial-resolution CE-MRA (voxel volume, 0.8 x 0.7 x 0.8) in a 43-year-old male patient with cervical AVM extending from C2 to C6. Note the left ascending cervical artery originating from the left thyrocervical trunk (arrowheads), appearing to course in a superior direction to feed the intramedullary AVM. This nidus drains via a prominent spinal vein into the right superior petrosal vein and into the right transverse sinus (arrow). B, VR reconstruction from high-spatial-resolution MRA. C and D, CCA of venous drainage. Note due to the small FOV, venous drainage is obtained by using separate injections. E and F, Superselective CCA from a thyrocervical trunk injection shows results consistent with those seen at MRA. G, Time-resolved MRA shows the nidus (arrowheads) and the draining vein (arrow).

View larger version (76K): [in this window] [in a new window]   Fig 3. A 27-year-old man status postembolization and radiosurgery for a left parieto-occipital AVM in 2003 who presented for follow-up study and assessment for repeat radiosurgery. A–E, High-spatial-resolution MRA images and corresponding CCA images are as follows: right lateral oblique (A) and coronal 3D VR images (B), coronal full-volume MIP (C), lateral projection from superselection and angiogram of the basilar artery (D), and coronal view from superselection and angiogram of the left internal carotid artery (E). Feeder arteries are identified by both techniques as angular branches of the left MCA and parieto-occipital branches of the left posterior cerebral artery (arrows). Single venous drainage into the superior sagittal sinus is identified by both techniques (arrowhead).

View larger version (89K): [in this window] [in a new window]   Fig 4. A, Time-resolved images with 1.5-second temporal resolution and 1.2 x 1 mm in-plane resolution from the same patient as in Fig 3. B, Coronal projection from the left internal carotid artery superselection and angiogram. Note sequential enhancement of the feeding arteries (arrows) and draining vein (arrowheads) by both techniques.

View larger version (168K): [in this window] [in a new window]   Fig 5. A 51-year-old male patient with subarachnoid hemorrhage and right cerebellar AVM who underwent surgical resection of an AVM. A and B, Coronal view from superselection and angiogram of the left vertebral artery (A) and its lateral projection (B) before therapy shows the AVM nidus (arrows). Follow-up CCA (C, coronal view and D, lateral projection) and follow-up MRA (E–H) images demonstrate complete obliteration of the AVM and no evidence of early draining vein. Corresponding high-spatial-resolution MRA and time-resolved images are as follows: coronal view of posterior circulation (both vertebral arteries) (E), saggital view (F), coronal full-volume MIP (G), and time-resolved MRA (H). MRA confirms the complete obliteration of the AVM.