4D-MRA in combination with selective arterial spin labelling (sASL) for characterization of arteriovenous malformations at 3 T

Purpose: Prospective evaluation of 4D-MRA in combination with selective arterial spin labelling (sASL) for pre- and postoperative assessment of cerebral arteriovenous malformations (AVMs).

Materials and Methods: In a prospective intraindividual comparative study 10 patients (6 female, 4 male; mean age 35.8 years±12.2; range 20–58 years) diagnosed with symptomatic cerebral AVMs underwent pre- and postoperative 4D-MRA, regional brain perfusion imaging using selective arterial spin labelling and digital subtraction angiography (DSA). Institutional ethics committee approval and written informed consent were obtained. 4D-MRA was performed using CENTRA keyhole in combination with view sharing yielding a temporal resolution of 572 msec, a whole brain coverage and an isotropic voxel size of 1.1×1.1×1.1mm³. Selective arterial spin labelling was performed using the PULSAR labelling sequence for selective labelling of both carotid arteries and the vertebrobasilar complex. All images were pre- and postoperatively assessed by two radiologists in consensus. In all cases DSA served as the standard of reference.

Results: 4D-MRA was successfully performed in 20/20 exams and enabled the same Spetzler-Martin classification as that in DSA in all cases (100%). Postoperative assessment confirmed complete resection of all AVMs in 100% yielding a 100% concordance between 4D-MRA in combination with selective arterial spin labelling and DSA.

Conclusion: 4D-MRA in combination with selective arterial spin labelling is a promising tool for pre- and postoperative assessment of cerebral AVMs providing functional information.