Artikel
Qualitative and quantitative assessment of arteriovenous malformation architecture at 7 Tesla MRI
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Autoren
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Bixia Chen
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Deutschland
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Toshinori Matsushige
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, essen, germanz; Department of Neurosurgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Philipp Dammann
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Deutschland
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Tobias Schoemberg
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Deutschland
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Mark E. Ladd
- Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Germanz; Medizinische Physik in der Radiologie, Deutsches Krebsforschungszentrum, Heidelberg, Deutschland
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Ulrich Sure
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Essen, Deutschland
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Karsten H. Wrede
- Klinik für Neurochirurgie, Universitätsklinikum Essen, Universität Duisburg-Essen, Erwin L. Hahn Institute for Magnetic Resonance Imaging, Universität Duisburg-Essen, Essen, Deutschland
| Veröffentlicht: | 9. Juni 2017 |
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Gliederung
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Objective: Identification and characterization of cerebral arteriovenous malformation (AVM) architecture is essential for treatment planning. This prospective clinical study aims to evaluate signal characteristics of arterial feeders, nidus and venous drainage in cerebral AVMs using 7 Tesla (T) MRI.
Methods: Ten adult patients suffering from cerebral AVM were examined using 7T MRI. The study was conducted according to the principles expressed in the Declaration of Helsinki and was approved by the local university institutional review board. Written informed consent was obtained before each examination. Imaging was performed on a whole-body MRI system (Magnetom 7T, Siemens Healthcare, Erlangen, Germany) utilizing a 1/32-channel transmit/receive head coil (Nova Medical, Wilmington, USA). Acquired sequences included TOF, MPRAGE (non-enhanced and enhanced), and SWI. Two experienced readers evaluated arterial feeders, AVM nidus and venous drainage in consensus. Additionally, AVMs were segmented manually for each patient by both raters. After co-registration of the 3 acquired MRI sequences, signal intensity histograms (249 bins) were calculated for the extracted feeders, AVM nidus and drainage, respectively.
Results: The patient group comprised 5 male and 5 female subjects. Mean age was 38 years (range: 22-52 years). Arterial AVM feeders were delineated excellently in TOF sequences, correlating with narrow ranges of high signal intensities in the histograms. On the contrary, MPRAGE and SWI delineated AVM feeders heterogeneously with histograms showing a variable and wide signal intensity distribution. Delineation of the AVM nidus was homogeneous in TOF, MPRAGE and SWI for the majority of patients and histograms showed homogeneous signal intensity distributions. The venous drainage appeared inhomogeneous in all acquired sequences with hyperintense as well as hypointense findings. Intensity histograms reflect these results with variable peaks at all intensity levels.
Conclusion: Vessel delineation with 7T MRI is excellent for AVMs. However, in contrast to conventional examinations that depict arterial feeders, AVM nidus and venous drainage homogeneously, identification of the AVM architecture remains challenging in 7T MRI. Due to the signal heterogeneity especially in the feeders and drainage these structures might be misinterpreted in some cases.
