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Non-contrast-enhanced 4D MR angiography with STAR spin labeling and variable flip angle sampling: a feasibility study for the assessment of Dural Arteriovenous Fistula

  • Diagnostic Neuroradiology
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Abstract

Introduction

This study aimed to evaluate the feasibility of non-contrast-enhanced 4D magnetic resonance angiography (NCE 4D MRA) with signal targeting with alternative radiofrequency (STAR) spin labeling and variable flip angle (VFA) sampling in the assessment of dural arteriovenous fistula (DAVF) in the transverse sinus.

Methods

Nine patients underwent NCE 4D MRA for the evaluation of DAVF in the transverse sinus at 3 T. One patient was examined twice, once before and once after the interventional treatment. All patients also underwent digital subtraction angiography (DSA) and/or contrast-enhanced magnetic resonance angiography (CEMRA). For the acquisition of NCE 4D MRA, a STAR spin tagging method was used, and a VFA sampling was applied in the data readout module instead of a constant flip angle. Two readers evaluated the NCE 4D MRA data for the diagnosis of DAVF and its type with consensus. The results were compared with those from DSA and/or CEMRA.

Results

All patients underwent NCE 4D MRA without any difficulty. Among seven patients with patent DAVFs, all cases showed an early visualization of the transverse sinus on NCE 4D MRA. Except for one case, the type of DAVF of NCE 4D MRA was agreed with that of reference standard study. Cortical venous reflux (CVR) was demonstrated in two cases out of three patients with CVR.

Conclusion

NCE 4D MRA with STAR tagging and VFA sampling is technically and clinically feasible and represents a promising technique for assessment of DAVF in the transverse sinus. Further technical developments should aim at improvements of spatial and temporal coverage.

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Conflict of interest

PS, IK and MP are employees of Siemens Healthcare.

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Authors and Affiliations

  1. Department of Radiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea

    Jinhee Jang, Bom-yi Kim, Hyun Seok Choi, So-Lyung Jung, Kook-Jin Ahn & Bum-soo Kim

  2. Healthcare Sector, Siemens AG, Erlangen, Germany

    Peter Schmitt

  3. Healthcare, Siemens AG, Seoul, South Korea

    Inseong Kim & Munyoung Paek

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  1. Jinhee Jang
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  2. Peter Schmitt
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Correspondence to Bum-soo Kim.

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Jang, J., Schmitt, P., Kim, By. et al. Non-contrast-enhanced 4D MR angiography with STAR spin labeling and variable flip angle sampling: a feasibility study for the assessment of Dural Arteriovenous Fistula. Neuroradiology 56, 305–314 (2014). https://doi.org/10.1007/s00234-014-1336-0

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  • DOI: https://doi.org/10.1007/s00234-014-1336-0

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