High-resolution MR venography of cerebral arteriovenous malformations
High-resolution MR venography of cerebral arteriovenous malformations
复制标题
DOI：
10.1016/s0730-725x(99)00084-3
复制
发表时间：
1999-12-01
影响因子：
2.5
通讯作者：
Kaiser, WA
中科院分区：
文献类型：
--
作者：
Essig, M;Reichenbach, JR;Kaiser, WA
为了评价高分辨率磁共振(MR)静脉成像技术在脑动静脉畸形(AVMS)患者中的诊断价值，使用高分辨率3D梯度回波序列和长回波时间TE来获取细至亚像素大小的血管直径为数百微米的静脉信息。该方法基于脱氧血红蛋白的顺磁性，以及在长回波时间下静脉和脑实质之间的发育相位差异，从而导致信号抵消。以常规数字减影血管造影为金标准，采用定性和定量的方法，将重建的静脉图像与飞行时间(TOF)-MR血管成像进行比较。在17例经血管造影证实的脑动静脉畸形患者中，该方法显示了其临床应用的潜力。静脉造影术能够发现所有的动静脉畸形，而TOF-MRA在3例患者中失败。在描绘静脉引流模式方面，MR静脉造影优于TOF-MRA，然而，该方法未能如预期的那样检出约一半的主要供血动脉。由于空气/组织边界的易感性伪影和对顺磁性含铁血黄素的干扰，静脉造影对于10名位于颅底附近或有出血史的动静脉畸形患者的准确病灶大小和形状的描绘受到限制。尽管引流静脉的可视化是脑动静脉畸形手术和放射外科治疗计划的重要前提，但高分辨率磁共振静脉成像在其中一些患者的诊断工作中的应用可能受到限制。另一方面，对于用其他MR方法难以诊断的小型动静脉动静脉畸形的早期发现和评估可能具有特别重要的意义。(C)1999年爱思唯尔科学公司。
The purpose of this study was to evaluate the diagnostic potential of a high-resolution magnetic resonance (MR) venography technique in patients with cerebral arteriovenous malformations (AVMs), A high-resolution 3D gradient echo sequence was used with a long echo time TE to obtain venous information down to sub-pixel sized vessel diameters of several hundred microns. The method is based on the paramagnetic property of deoxyhemoglobin, and the resulting developing phase difference between veins and brain parenchyma at long echo times which leads to signal cancellation. The reconstructed venograms were compared with time-of-flight (TOF)-MR angiography using qualitative and quantitative criteria with the conventional digital subtraction angiography serving as the reference gold standard. In 17 patients with angiographically proven cerebral AVMs, the method indicates its potential in clinical applications. Venography was able to detect all AVMs whereas TOF-MRA failed in three patients. In the delineation of venous drainage patterns MR venography was superior to TOF-MRA, however, the method failed in the detection of about half of the main feeding arteries, as expected. Due to susceptibility artifacts at air/tissue boundaries and interference with paramagnetic hemosiderin, venography was limited with respect to the delineation of the exact nidus sizes and shapes in ten patients with AVMs located close to the skull base or having suffered from previous bleeding. Although the visualization of draining veins represents an important prerequisite in the surgical and radiosurgical treatment planning of cerebral AVMs, application of high resolution MR venography may be limited in the diagnostic work-up in some of these patients. On the other hand, it may be of special importance in the early detection and assessment of small AVMs that are difficult to diagnose with other MR methods. (C) 1999 Elsevier Science Inc.