TY - JOUR
T1 - Vessel-selective 4D-MR angiography using super-selective pseudo-continuous arterial spin labeling may be a useful tool for assessing brain AVM hemodynamics
AU - Togao, Osamu
AU - Obara, Makoto
AU - Helle, Michael
AU - Yamashita, Koji
AU - Kikuchi, Kazufumi
AU - Momosaka, Daichi
AU - Kikuchi, Yoshitomo
AU - nishimura, ataru
AU - Arimura, Koichi
AU - Wada, Tatsuhiro
AU - Murazaki, Hiroo
AU - Iihara, Koji
AU - Van Cauteren, Marc
AU - Akio, Hiwatashi
N1 - Funding Information:
This work was supported by JSPS KAKENHI Grant Number JP17K10410 and JP20K08111. Acknowledgements
Publisher Copyright:
© 2020, European Society of Radiology.
PY - 2020/12/1
Y1 - 2020/12/1
N2 - Objectives: To evaluate the usefulness of 4D-MR angiography based on super-selective pseudo-continuous ASL combined with keyhole and view-sharing (4D-S-PACK) for vessel-selective visualization and to examine the ability of this technique to visualize brain arteriovenous malformations (AVMs). Methods: In this retrospective study, 15 patients (ten men and five women, mean age 44.0 ± 16.9 years) with brain AVMs were enrolled. All patients were imaged with 4D-PACK (non-selective), 4D-S-PACK, and digital subtraction angiography (DSA). Observers evaluated vessel selectivity, identification of feeding arteries and venous drainage patterns, visualization scores, and contrast-to-noise ratio (CNR) for each AVM component. Measurements were compared between the MR methods. Results: Vessel selectivity was graded 4 in 43/45 (95.6%, observer 1) and 42/45 (93.3%, observer 2) territories and graded 3 in two (observer 1) and three (observer 2) territories. The sensitivity and specificity for identification of feeding arteries for both observers was 88.9% and 100% on 4D-PACK, and 100% and 100% on 4D-S-PACK, respectively. For venous drainage, the sensitivity and specificity was 100% on both methods for observer 1. The sensitivity and specificity for observer 2 was 94.4% and 83.3% on 4D-PACK, and 94.4% and 91.7% on 4D-S-PACK, respectively. The CNRs at the timepoint of 1600 ms were slightly lower in 4D-S-PACK than in 4D-PACK for all AVM components (Feeding artery, p =.02; nidus, p =.001; and draining artery, p =.02). The visualization scores for both observers were not significantly different between 4D-PACK and 4D-S-PACK for all components. Conclusions: 4D-S-PACK could be a useful non-invasive clinical tool for assessing hemodynamics in brain AVMs. Key Points: • The 4D-MR angiography based on super-selective pseudo-continuous arterial spin labeling combined with CENTRA-keyhole and view-sharing (4D-S-PACK) enabled excellent vessel selectivity. • The 4D-S-PACK enabled the perfect identification of feeding arteries of brain arteriovenous malformation (AVM). • 4D-S-PACK could be a non-invasive clinical tool for assessing hemodynamics in brain AVMs.
AB - Objectives: To evaluate the usefulness of 4D-MR angiography based on super-selective pseudo-continuous ASL combined with keyhole and view-sharing (4D-S-PACK) for vessel-selective visualization and to examine the ability of this technique to visualize brain arteriovenous malformations (AVMs). Methods: In this retrospective study, 15 patients (ten men and five women, mean age 44.0 ± 16.9 years) with brain AVMs were enrolled. All patients were imaged with 4D-PACK (non-selective), 4D-S-PACK, and digital subtraction angiography (DSA). Observers evaluated vessel selectivity, identification of feeding arteries and venous drainage patterns, visualization scores, and contrast-to-noise ratio (CNR) for each AVM component. Measurements were compared between the MR methods. Results: Vessel selectivity was graded 4 in 43/45 (95.6%, observer 1) and 42/45 (93.3%, observer 2) territories and graded 3 in two (observer 1) and three (observer 2) territories. The sensitivity and specificity for identification of feeding arteries for both observers was 88.9% and 100% on 4D-PACK, and 100% and 100% on 4D-S-PACK, respectively. For venous drainage, the sensitivity and specificity was 100% on both methods for observer 1. The sensitivity and specificity for observer 2 was 94.4% and 83.3% on 4D-PACK, and 94.4% and 91.7% on 4D-S-PACK, respectively. The CNRs at the timepoint of 1600 ms were slightly lower in 4D-S-PACK than in 4D-PACK for all AVM components (Feeding artery, p =.02; nidus, p =.001; and draining artery, p =.02). The visualization scores for both observers were not significantly different between 4D-PACK and 4D-S-PACK for all components. Conclusions: 4D-S-PACK could be a useful non-invasive clinical tool for assessing hemodynamics in brain AVMs. Key Points: • The 4D-MR angiography based on super-selective pseudo-continuous arterial spin labeling combined with CENTRA-keyhole and view-sharing (4D-S-PACK) enabled excellent vessel selectivity. • The 4D-S-PACK enabled the perfect identification of feeding arteries of brain arteriovenous malformation (AVM). • 4D-S-PACK could be a non-invasive clinical tool for assessing hemodynamics in brain AVMs.
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U2 - 10.1007/s00330-020-07057-4
DO - 10.1007/s00330-020-07057-4
M3 - Article
C2 - 32696254
AN - SCOPUS:85088278276
SN - 0938-7994
VL - 30
SP - 6452
EP - 6463
JO - European Radiology
JF - European Radiology
IS - 12
ER -