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60th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Benelux countries and Bulgaria

German Society of Neurosurgery (DGNC)

24 - 27 May 2009, Münster

TOF- and 4D-MRA for therapy planning in cerebral arteriovenous malformations

Meeting Abstract

  • J. Fiehler - Neuroradiologische Abteilung, Universitätklinikum Hamburg-Eppendorf
  • J. Regelsberger - Neurochirurgische Klinik, Universitätklinikum Hamburg-Eppendorf
  • S. Siemonsen - Neuroradiologische Abteilung, Universitätklinikum Hamburg-Eppendorf
  • M. Piening - Neuroradiologische Abteilung, Universitätklinikum Hamburg-Eppendorf
  • H. Zeumer - Neuroradiologische Abteilung, Universitätklinikum Hamburg-Eppendorf

Deutsche Gesellschaft für Neurochirurgie. 60. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit den Benelux-Ländern und Bulgarien. Münster, 24.-27.05.2009. Düsseldorf: German Medical Science GMS Publishing House; 2009. DocDI.06-02

DOI: 10.3205/09dgnc145, URN: urn:nbn:de:0183-09dgnc1450

Published: May 20, 2009

© 2009 Fiehler et al.
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Outline

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Objective: Digital subtraction angiography (DSA) is still the gold standard in diagnosing cerebral arteriovenous malformations (cAVMs). Time- and colour-coded MR-angiography was performed in order to improve the understanding of the angioarchitecture of cAVMs.

Methods: In addition to standard MR-Angiography, T1 and T2-weighted sequences a 3D time-resolved echo-shared MR-angiography (TREAT) and high-resolution susceptibility weighted imaging (SWI) were used in 20 AVM-patients. Parallel imaging with an auto-calibrating factor of two allowed acquisition of one 3D data set in 0.5 seconds. This dataset was spatially co-registered with a 3D time-of-flight angiography after contrast with a resolution of 0.5x0.5x0.5 mm. The results were compared to conventional DSA, serving as control.

Results: In all patients multiplanar visualization of the nidus allowed a time and coded-coded filling of the AVM comparable to DSA. All feeding and draining vessels were identified in the TREAT sequences. Incomplete spatial coverage of 3D volume was limiting the diagnostic capability in one patient and low spatial resolution in another.

Conclusions: Planning the neurosurgical procedure 4D-MRA was most helpful offering an angiographic like arteriovenous flow in addition of the well-known MR-sequences. TREAT sequences may be the future of non-invasive diagnosis in cAVMs combining conventional MRI with time- and coded-coded 3D-images. However, super-selective catheterization will remain an absolute prerequisite during a pre-surgical embolization procedure.