Intracranial Arteriovenous Malformation: Time-resolved Contrast-enhanced MR Angiography with Combination of Parallel Imaging, Keyhole Acquisition, and k-Space Sampling Techniques at 1.5 T

doi:10.1148/radiol.2463070293

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Neuroradiology

Intracranial Arteriovenous Malformation: Time-resolved Contrast-enhanced MR Angiography with Combination of Parallel Imaging, Keyhole Acquisition, and k-Space Sampling Techniques at 1.5 T¹

Christian A. Taschner, MD, Jürgen Gieseke, PhD, Vianney Le Thuc, PhD, Henda Rachdi, MD, Nicolas Reyns, MD, Jean-Yves Gauvrit, MD, and Xavier Leclerc, MD

¹ From the Departments of Neuroradiology (C.A.T., V.L.T., H.R., J.Y.G., X.L.) and Neurosurgery (N.R.), Hôpital Roger Salengro, University Hospital Lille, Rue Emile Laine, F-59037 Lille Cédex, France; and Philips Medical Systems, MR Clinical Science, Best, the Netherlands (J.G.). Received February 12, 2007; revision requested April 13; revision received June 12; accepted July 18; final version accepted August 30. C.A.T. supported by a research grant from the Swiss National Science Foundation that was funded by the L. + Th. Laroche Stiftung, Basel, Switzerland. Address correspondence to C.A.T. (e-mail: c.taschner{at}web.de).

Purpose:To prospectively compare the agreement between digital subtractionangiography (DSA) and time-resolved magnetic resonance (MR) angiographywith sensitivity encoding (SENSE) in combination with keyhole acquisitionand contrast material–enhanced robust-timing angiography (CENTRA)k-space sampling techniques for the characterization of intracranialarteriovenous malformations (AVMs).

Materials and Methods:The institutional review board approved thestudy; informed consent was obtained from all patients (or theirparents). Twenty-eight patients (15 male, 13 female; mean age, 38.6years; age range, 16–61 years) with 29 previously diagnosed,untreated intracranial AVMs who were referred for stereotactic gammaknife radiosurgery were evaluated. Preinterventional imaging includedintraarterial DSA and time-resolved MR angiography. The time-resolvedMR angiography sequence included SENSE with a 1.5-T imager and wasoptimized by applying keyhole acquisition and CENTRA techniques.Time-resolved MR angiograms were reviewed by two independent ratersand compared with DSA images with regard to arterial feeders, nidussize, and venous drainage. ${kappa}$ Statistics were applied to determineinterobserver and intermodality agreement.

Results:MR angiography enabled time-resolved (1.7 seconds per volume)visualization of cerebral vessels from axis to vertex at high spatialresolution (true voxel size, 1 x 1 x 2 mm). All 25 nidi detectedat intraarterial DSA were visualized at time-resolved MR angiography.Intermodality agreement was excellent for arterial feeders ( ${kappa}$ = 0.91;95% confidence interval [CI]: 0.786, 1.000) and venous drainage ( ${kappa}$ = 0.94; 95% CI: 0.814, 1.000) and was good for nidus size ( ${kappa}$ = 0.76;95% CI: 0.562, 0.950).

Conclusion:The agreement (good to excellent) between time-resolvedMR angiographic and DSA findings suggests that time-resolved MR angiographyis a reliable tool for the characterization of intracranial AVMswith respect to arterial feeders, nidus size, and venous drainage.