Time-Resolved Magnetic Resonance Angiography for Follow-Up of Treated Dural and Epidural Spinal Arteriovenous Fistula

2021 ◽  
Author(s):  
Giovanni Giulio Vercelli ◽  
Fabrizio Venturi ◽  
Massimiliano Minardi ◽  
Fabio Cofano ◽  
Francesco Zenga ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Vascular Malformations ◽  
High Sensitivity ◽  
Recurrence Time ◽  
Venous Plexus ◽  
Time Resolved ◽  
Arteriovenous Fistulas ◽  
Spinal Arteriovenous Fistula

Abstract Background Spinal arteriovenous fistulas (AVFs) are uncommon vascular malformations of spinal dural and epidural vessels. Actually digital subtraction angiography (DSA) is the gold standard for diagnosis and follow-up. The aim of this study is to demonstrate the validity of the multiphasic magnetic resonance angiography (MRA) to identify recurrent/residual AVFs or their correct surgical and/or endovascular closure. Methods A retrospective cases series with perimedullary venous plexus congestion due to spinal dural or epidural AVF was performed at our center from April 2014 to September 2019. After 1 month from treatment, the patients were subjected to time-resolved MRA and DSA to demonstrate recurrence or correct closure of AVFs. Results We collected a series of 26 matched time-resolved MRA and DSA in 20 patients who underwent an endovascular and/or surgical procedure. In our series, we reported five cases of recurrence. Time-resolved MRA detected six cases of recurrence, with 100% sensitivity and 95% specificity (p < 0.001). We used DSA as the standard reference. Conclusion Time-resolved MRA is a valid tool in posttreatment follow-up to detect recurrent or residual AVFs. It has high sensitivity and specificity and may replace DSA.

scholarly journals The use of contrast-enhanced, time-resolved magnetic resonance angiography in cerebrovascular pathology

2019 ◽  
Vol 47 (6) ◽  
pp. E3 ◽  
Author(s):  
Jonathan A. Grossberg ◽  
Brian M. Howard ◽  
Amit M. Saindane
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Best Practices ◽  
Imaging Modality ◽  
Digital Subtraction ◽  
Time Resolved ◽  
Contrast Enhanced ◽  
Contrast Allergy

Digital subtraction angiography (DSA) has long been the imaging gold standard in the evaluation, treatment, and follow-up of cerebro- and spinovascular disorders. However, DSA has the disadvantages of invasiveness, contrast allergy or nephropathy, the impracticality of procedural preparation and recovery, and expense. Contrast-enhanced (CE), time-resolved (TR) magnetic resonance angiography (CE TR-MRA) is a sophisticated, relatively novel imaging modality that provides multiphasic contrast-enhanced visualization of the neurovasculature. Given the crucial role of angiography in all aspects of care for patients with complex neurovascular disorders, it is incumbent on those who care for these patients to understand the usefulness and pitfalls of novel imaging in this arena to ensure best practices, and to deliver cutting edge care to these patients in a way that minimizes cost, but does not compromise quality. CE TR-MRA has the potential to play an expanded role in the workup and follow-up across the spectrum of neurovascular disease, and this review is aimed to help neurosurgeons better understand how CE TR-MRA can be used to better manage patients in this cohort.

scholarly journals Relative signal intensity on time-of-flight magnetic resonance angiography as a novel indicator of aggressive presentation of intracranial dural arteriovenous fistulas

2020 ◽  
pp. 0271678X2096921
Author(s):  
Bikei Ryu ◽  
Shinsuke Sato ◽  
Tatsuki Mochizuki ◽  
Yasunari Niimi
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Aggressive Behavior ◽  
Signal Intensity ◽  
Time Of Flight ◽  
Area Under The Curve ◽  
High Sensitivity ◽  
Relative Signal Intensity ◽  
Arteriovenous Fistulas ◽  
Dural Arteriovenous Fistulas

Asymptomatic dural arteriovenous fistulas (DAVFs) with cortical venous reflux (CVR) are now more commonly encountered. However, patients with an incidental onset may have a less aggressive clinical course. It is desirable to explore methods and indicators to predict the clinical outcomes. This study investigates whether the relative signal intensity (rSI) of the draining vessels on the time-of-flight magnetic resonance angiography is related to clinical behavior in patients with intracranial DAVFs. We retrospectively reviewed 36 intracranial DAVFs. The patients were categorized as those with either aggressive-presentation or non-aggressive-presentation (n = 16 and 20, respectively). The rSIs of the shunt points, affected sinuses, and veins with CVR were compared between the two groups. The two groups were not significantly different in terms of rSIs of the shunt points and affected sinuses (p = 0.37 and 0.41, respectively). However, a significant positive correlation was observed in the rSI of the veins with CVR between the aggressive and non-aggressive behavior groups (p < 0.0001). The rSI of the veins with CVR could serve as a reliable indicator of aggressive behavior in intracranial DAVFs, and its optimal cutoff value was 1.63 with high sensitivity and specificity for predicting aggressive behavior (area under the curve, 0.909).

scholarly journals Time-resolved magnetic resonance angiography as a follow-up method for visceral artery aneurysm treated with coil-embolisation

2018 ◽  
Vol 83 ◽  
pp. 137-142
Author(s):  
Tatsuya Kawai ◽  
Masashi Shimohira ◽  
Kazushi Suzuki ◽  
Kengo Ohta ◽  
Kenichiro Kurosaka ◽  
...  
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Artery Aneurysm ◽  
Visceral Artery ◽  
Visceral Artery Aneurysm ◽  
Coil Embolisation ◽  
Time Resolved

Decrease in Secondary Neck Vessels in Multiple Sclerosis: A 5-year Longitudinal Magnetic Resonance Angiography Study

2019 ◽  
Vol 16 (3) ◽  
pp. 215-223 ◽  
Author(s):  
Dejan Jakimovski ◽  
Matthew Topolski ◽  
Kana Kimura ◽  
Virja Pandya ◽  
Bianca Weinstock-Guttman ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Longitudinal Change ◽  
Repeated Measure ◽  
Cross Sectional ◽  
False Discovery ◽  
The Common ◽  
Neck Vessels

Background: Studies have previously shown greater arterial and venous extracranial vascular changes in persons with multiple sclerosis (PwMS) when compared to healthy controls (HCs). Objectives: To determine the change in the number and size of secondary neck vessels in PwMS and HCs over a 5-year follow-up period. Methods: Both at baseline and follow-up, 83 PwMS and 25 HCs underwent magnetic resonance angiography (MRA) imaging and analysis. The number and cross-sectional area (CSA) of all secondary neck vessels (excluding the common/internal carotid, vertebral artery, and internal jugular vein) measured at levels from C2-T1 were determined by semi-automated edge detection/ contouring software. The longitudinal change in the number and CSA of the secondary neck vessels from the PwMS and HCs were analyzed by non-parametric Wilcoxon repeated measure. Benjamini-Hochberg procedure adjusted for false discovery rate (FDR). Results: For over 5 years, PwMS demonstrated a consistent longitudinal decrease in both the number of secondary neck vessels (Z-change between -3.3 and -5.4, q=0.001) and their CSA (Zchange between -2.9 and -5.2, q=0.004). On the contrary, the HCs did not demonstrate a significant longitudinal change in secondary neck vessels over the follow-up period. Due to the longitudinal decrease, the PwMS showed a lower number of secondary neck vessels when compared to HCs measured at follow-up (p<0.029, except for C4 with trending p=0.071). The PwMS changes were also corroborated within each MS phenotype. Conclusion: PwMS demonstrate a significant mid-term decrease in the number and the size of the secondary neck vessels. The clinical relevance of these findings and the effect on intracranial blood flow are currently unknown.

scholarly journals MRA Mapping and Selective Embolization of a Large Uterine Cavity Pseudoaneurysm at 20 Weeks of Gestation

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Jean V. Storey ◽  
Timothy B. Dinh ◽  
Deirdre M. McCullough ◽  
Steven H. Craig ◽  
Christian L. Carlson
Keyword(s):  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Mortality Risk ◽  
Vascular Malformations ◽  
Uterine Cavity ◽  
Massive Hemorrhage ◽  
Fetal Mortality ◽  
Intravenous Contrast ◽  
Selective Embolization ◽  
Contrast Enhanced

Antepartum uterine cavity pseudoaneurysm rupture can cause massive hemorrhage with high maternal and fetal mortality risk. Invasive placentation can predispose to vascular malformations. We present a novel use of macrocyclic intravenous contrast-enhanced magnetic resonance angiography for preprocedure planning followed by selective low radiation embolization of a uterine cavity pseudoaneurysm in the setting of invasive placentation at 20 weeks of gestation. To our knowledge, this is the first reported case of uterine cavity pseudoaneurysm successfully mapped with MRA and treated with embolization at 20 weeks of gestation.

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