Interest of HYPR flow dynamic MRA for characterization of cerebral arteriovenous malformations: comparison with TRICKS MRA and catheter DSA.

Abstract

OBJECTIVE:

HYPR flow is a 3D dynamic contrast-enhanced MRA technique providing isotropic sub-millimetre resolution with half-second temporal resolution. We compared HYPR flow and time-resolved imaging of contrast kinetics (TRICKS) MRA for the characterization of cerebral arteriovenous malformations (cAVMs), using catheter DSA as reference.

METHODS:

Twenty-two patients underwent HYPR flow and TRICKS MRA within 15 days of DSA. HYPR flow and TRICKS datasets were reviewed separately by two readers for image quality, Spetzler-Martin grade, venous ectasia, and deep venous drainage.

RESULTS:

Image quality was better for HYPR flow than for TRICKS (narrower full width at half maximum; larger arterial diagnostic window; greater number of arterial frames, P ≤ 0.05). Using HYPR flow, inter-reader agreement was excellent for all cAVM characteristics. The agreement with DSA for the overall Spetzler-Martin grade was excellent for HYPR flow (ICC = 0.96 and 0.98, depending on the reader) and TRICKS (ICC = 0.82 and 0.95). In comparison to TRICKS, HYPR flow showed higher concordance with DSA for the identification of venous ectasia and deep venous drainage.

CONCLUSION:

Owing to an excellent agreement with DSA with respect to depiction of the vascular architecture of cAVMs, HYPR flow could be useful for the non-invasive characterization of cAVMs.

KEY POINTS:

• Dynamic MRA is used for cerebral AVM depiction and follow-up • HYPR flow is a new, highly-resolved dynamic MRA sequence • HYPR flow provides whole brain coverage • HYPR flow provides excellent agreement with the Spetzler-Martin grade • Compared to TRICKS MRA, HYPR flow improves cerebral AVM characterization.

• Authors: Raphaël Dautry, Myriam Edjlali, Pauline Roca, Cécile Rabrait, Yijing Wu, Kevin Johnson, Olivier Wieben, Denis Trystram, Christine Rodriguez-Régent, Fawaz Alshareef, Patrick Turski, Jean-François Meder, Olivier Naggara, Catherine Oppenheim
• Journal: European radiology (Eur Radiol) Vol. 25 Issue 11 Pg. 3230-7 (Nov 2015) ISSN: 1432-1084 [Electronic] Germany
• PMID: 25916388 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Contrast Media

Topics

• Adult
• Angiography, Digital Subtraction (methods)
• Catheterization (methods)
• Cerebral Angiography (methods)
• Contrast Media
• Female
• Hemodynamics (physiology)
• Humans
• Imaging, Three-Dimensional (methods)
• Intracranial Arteriovenous Malformations (pathology, physiopathology)
• Kinetics
• Magnetic Resonance Angiography (methods)
• Male
• Middle Aged
• Prospective Studies
• Young Adult