RT Journal Article
SR Electronic
T1 Time-Resolved Spinal MR Angiography: Initial Clinical Experience in the Evaluation of Spinal Arteriovenous Shunts
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 1806
OP 1810
DO 10.3174/ajnr.A0639
VO 28
IS 9
A1 S. Ali
A1 T.A. Cashen
A1 T.J. Carroll
A1 E. McComb
A1 M. Muzaffar
A1 A. Shaibani
A1 M.T. Walker
YR 2007
UL http://www.ajnr.org/content/28/9/1806.abstract
AB BACKGROUND AND PURPOSE: Spinal arteriovenous shunts usually require digital subtraction angiography (DSA) for evaluation. We report a unique time-resolved spinal MR angiographic (TRSMRA) technique with a temporal resolution of 3–6 seconds and spatial resolution of approximately 1 mm3 that has the potential to noninvasively detect, localize, and follow-up these cases.MATERIALS AND METHODS: Eleven patients with clinical presentation and/or MR findings suspicious for a spinal arteriovenous shunt were referred for TRSMRA. Patients subsequently underwent spinal DSA to confirm the presence or absence of a shunt or were followed clinically until an alternative diagnosis was found. TRSMRA was also used to predict the level of the shunt in the positive cases. In addition, 2 of these patients as well as a 12th patient referred to us posttreatment received a follow-up TRSMRA to assess treatment outcome.RESULTS: Early venous shunting was identified by using TRSMRA in 6 cases. All 6 were confirmed to have an AV shunt on subsequent spinal DSA. The shunt level predicted by TRSMRA consistently correlated with DSA to within 1 vertebral level. In the 5 patients with a negative screening TRSMRA, DSA or clinical outcome confirmed the absence of an arteriovenous shunt in all of the cases. Posttreatment TRSMRA in 3 patients accurately assessed the success or failure of treatment.CONCLUSION: Combining acceleration techniques to achieve high frame rate TRSMRA provides sufficient temporal and spatial resolution to identify, localize, and follow patients suspected of having a spinal arteriovenous shunt. Further study in a larger population is warranted to assess the accuracy of this technique.