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Utility of susceptibility-weighted imaging and arterial spin perfusion imaging in pediatric brain arteriovenous shunting

  • Paediatric Neuroradiology
  • Published:
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Abstract

Introduction

The objectives of the study are to investigate the application of susceptibility-weighted imaging (SWI) and arterial spin labeling (ASL) imaging in the assessment of shunting and the draining veins in pediatric patients with arteriovenous shunting and compare the utility of SWI and ASL with conventional MR and digital subtraction angiography (DSA).

Methods

This study is a retrospective study of 19 pediatric patients with arteriovenous shunting on brain MRI who were also evaluated with DSA. We assessed the ability of conventional MRI sequences, susceptibility magnitude images, phase-filtered SWI images, and pulsed ASL images in the detection of arteriovenous (AV) shunting, number of draining veins and drainage pathways in comparison to DSA.

Results

The mean number of detected draining veins on DSA (3.63) was significantly higher compared to SWI phase-filtered image (mean = 2.72), susceptibility magnitude image (mean = 2.92), ASL (mean = 1.76) and conventional MRI (2.47) (p < 0.05). Pairwise comparison of DSA difference scores (i.e., difference between MR modalities in the number of missed draining veins) revealed no difference between the MR modalities (p > 0.05). ASL was the only method that correctly identified superficial and deep venous drainage in all patients. Regarding detection of shunting, ASL, SWI phase-filtered, and magnitude images demonstrated shunting in 100, 83, and 84 % of patients, respectively.

Conclusion

SWI depicts a higher number of draining vein compared to conventional MR pulse sequences. ASL is a sensitive approach in showing 100 % sensitivity in the detection of AV shunting and in the diagnosis of the pattern of venous drainage. The present findings suggest the added utility of both SWI and ASL in the assessment of AV shunting.

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Ethical standards and patient consent

We declare that all human and animal studies have been approved by the IRB committee of Children’s Hospital of Philadelphia and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. Due to the retrospective nature of study, the IRB waived informed consent.

Conflict of interest

We declare that we have no conflict of interest.

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Authors and Affiliations

  1. Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA

    Seyed Ali Nabavizadeh, J. Christopher Edgar & Arastoo Vossough

  2. Department of Radiology, Children’s Hospital of Philadelphia, 324 S 34th Street – Wood 2115, Philadelphia, PA, 19104, USA

    Seyed Ali Nabavizadeh, J. Christopher Edgar & Arastoo Vossough

Authors
  1. Seyed Ali Nabavizadeh
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  2. J. Christopher Edgar
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  3. Arastoo Vossough
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Correspondence to Arastoo Vossough.

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Nabavizadeh, S.A., Edgar, J.C. & Vossough, A. Utility of susceptibility-weighted imaging and arterial spin perfusion imaging in pediatric brain arteriovenous shunting. Neuroradiology 56, 877–884 (2014). https://doi.org/10.1007/s00234-014-1408-1

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  • DOI: https://doi.org/10.1007/s00234-014-1408-1

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