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Non-Enhanced MR Imaging of Cerebral Arteriovenous Malformations at 7 Tesla

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Abstract

Objective

To evaluate prospectively 7 Tesla time-of-flight (TOF) magnetic resonance angiography (MRA) and 7 Tesla non-contrast-enhanced magnetization-prepared rapid acquisition gradient-echo (MPRAGE) for delineation of intracerebral arteriovenous malformations (AVMs) in comparison to 1.5 Tesla TOF MRA and digital subtraction angiography (DSA).

Methods

Twenty patients with single or multifocal AVMs were enrolled in this trial. The study protocol comprised 1.5 and 7 Tesla TOF MRA and 7 Tesla non-contrast-enhanced MPRAGE sequences. All patients underwent an additional four-vessel 3D DSA. Image analysis of the following five AVM features was performed individually by two radiologists on a five-point scale: nidus, feeder(s), draining vein(s), relationship to adjacent vessels, and overall image quality and presence of artefacts.

Results

A total of 21 intracerebral AVMs were detected. Both sequences at 7 Tesla were rated superior over 1.5 Tesla TOF MRA in the assessment of all considered AVM features. Image quality at 7 Tesla was comparable with DSA considering both sequences. Inter-observer accordance was good to excellent for the majority of ratings.

Conclusion

This study demonstrates excellent image quality for depiction of intracerebral AVMs using non-contrast-enhanced 7 Tesla MRA, comparable with DSA. Assessment of untreated AVMs is a promising clinical application of ultra-high-field MRA.

Key Points

• Non-contrast-enhanced 7 Tesla MRA demonstrates excellent image quality for intracerebral AVM depiction.

• Image quality at 7 Tesla was comparable with DSA considering both sequences.

• Assessment of intracerebral AVMs is a promising clinical application of ultra-high-field MRA.

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Acknowledgments

The authors would like to thank Lena C. Schäfer (RT) for performing all the 7 Tesla examinations.

The scientific guarantor of this publication is Dr. Karsten H. Wrede. The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article. This study has received funding by University Duisburg Essen (IFORES grant). Dr. Ulrike Krahn kindly provided statistical advice for this manuscript. Institutional Review Board approval was obtained. Written informed consent was obtained from all subjects (patients) in this study. Methodology: prospective, observational, multicenter study.

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Authors and Affiliations

  1. Erwin L. Hahn Institute for Magnetic Resonance Imaging, University Duisburg-Essen, 45141, Essen, Germany

    Karsten H. Wrede, Philipp Dammann, Sören Johst, Stefan Maderwald, Mark E. Ladd & Lale Umutlu

  2. Department of Neurosurgery, University Hospital Essen, Hufelandstrasse 55, 45147, Essen, Germany

    Karsten H. Wrede, Philipp Dammann, I. Erol Sandalcioglu & Ulrich Sure

  3. Department of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, 45147, Essen, Germany

    Christoph Mönninghoff, Marc Schlamann, Mark E. Ladd, Michael Forsting & Lale Umutlu

  4. Department of Neuroradiology, University Hospital Giessen, 35385, Giessen, Germany

    Marc Schlamann

  5. Department of Neurosurgery, Nordstadtkrankenhaus Hannover, 30167, Hannover, Germany

    I. Erol Sandalcioglu

  6. Division of Medical Physics in Radiology (E020), German Cancer Research Center (DKFZ), 69120, Heidelberg, Germany

    Mark E. Ladd

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  1. Karsten H. Wrede
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  11. Lale Umutlu
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Correspondence to Karsten H. Wrede.

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Wrede, K.H., Dammann, P., Johst, S. et al. Non-Enhanced MR Imaging of Cerebral Arteriovenous Malformations at 7 Tesla. Eur Radiol 26, 829–839 (2016). https://doi.org/10.1007/s00330-015-3875-0

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  • DOI: https://doi.org/10.1007/s00330-015-3875-0

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