American Journal of Neuroradiology 22:1633 (9 2001)
© 2001 American Society of Neuroradiology
ARTICLE
In Re: Griffiths PD, Hoggard N, Warren DJ, Wilkinson ID, Anderson B, Romanowski CA. Brain Arteriovenous Malformations: Assessment with Dynamic MR Digital Subtraction Angiography. AJNR Am J Neuroradiol 21:18921899
Joachim Klischa
a University Freiburg Freiburg, Germany
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Introduction
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I read with interest the article by Griffiths et al published
in the
AJNR (
1), in which the authors describe the early experience
with an experimental dynamic MR angiographic method using a
contrast agent and a digital mask for cerebral arteriovenous
malformation (AVM) assessment. We enjoy Griffiths et al's article
because they show again that MR digital subtraction angiography
(DSA) is a noninvasive, dynamic angiographic tool. It should
be noted that there are missing references in the reference
list of the article, and we would like to bring to your attention
that MR DSA already could be performed with two frames per second,
as described in our February 2000 article in
Neuroradiology (
2), as well as described by Strecker et al (
3,
4). MR-DSA today
can be performed with four frames per second when the projection
sequence is combined with view-sharing techniques (R. Strecker,
personal communication). Post-processing of images in MR-DSA
according to the algorithm proposed for functional MR imaging
offers several advantages with significant improvement of signal-to-noise
ratio of up to a factor of three, background suppression without
subtraction, and clear artery-vein separation, even in brain
vessels. By the use of these modifications, MR-DSA becomes a
promising clinical tool, eg, in the assessment of dural AVMs
and brain AVMs. However, all MR-DSA techniques described cannot
replace catheter angiography, with its high anatomic and temporal
resolution, for planning endovascular therapy.
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References
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Griffiths PD, Hoggard N, Warren DJ, Wilkinson ID, Anderson B, Romanowski CA. Brain arteriovenous malformations: assessment with dynamic MR digital subtraction angiography. AJNR Am J Neuroradiol 2000;21:1892-1899[Abstract/Free Full Text]
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Klisch J, Strecker R, Hennig J, Schumacher M. Time-resolved projection MRA: clinical applications in intracranial vascular malformations. Neuroradiology 2000;42:104-107[Medline]
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Strecker R, Scheffler K, Klisch J, Lehnhardt S, Winterer S, Laubenberger J, et al. Fast functional MRA using time-resolved projection MR-angiography with correlation analysis. Magn Reson Med 2000;43:303-309[Medline]
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Strecker R, Lehnhardt S, Klisch J, Hennig J. Functional MRA combining 2D MR DSA and correlation analysis. Proc Intl Magn Reson Med 1999;7:484