Validation of cerebral arteriovenous malformation hemodynamics assessed by DSA using quantitative magnetic resonance angiography: preliminary study

BackgroundThe hemodynamic evaluation of cerebral arteriovenous malformations (AVMs) using DSA has not been validated against true flow measurements.ObjectiveTo validate AVM hemodynamics assessed by DSA using quantitative magnetic resonance angiography (QMRA).Materials and methodsPatients seen at our institution between 2007 and 2016 with a supratentorial AVM and DSA and QMRA obtained before any treatment were retrospectively reviewed. DSA assessment of AVM flow comprised AVM arterial-to-venous time (A-Vt) and iFlow transit time. A-Vt was defined as the difference between peak contrast intensity in the cavernous internal carotid artery and peak contrast intensity in the draining vein. iFlow transit times were determined using syngo iFlow software. A-Vt and iFlow transit times were correlated with total AVM flow measured using QMRA and AVM angioarchitectural and clinical features.Results33 patients (mean age 33 years) were included. Nine patients presented with hemorrhage. Mean AVM volume was 9.8 mL (range 0.3–57.7 mL). Both A-Vt (r=−0.47, p=0.01) and iFlow (r=−0.44, p=0.01) correlated significantly with total AVM flow. iFlow transit time was significantly shorter in patients who presented with seizure but A-Vt and iFlow did not vary with other AVM angioarchitectural features such as venous stenosis or hemorrhagic presentation.ConclusionsA-Vt and iFlow transit times on DSA correlate with cerebral AVM flow measured using QMRA. Thus, these parameters may be used to indirectly estimate AVM flow before and after embolization during angiography in real time.

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Intracranial internal carotid artery changes in acromegaly: a quantitative magnetic resonance angiography study

Pituitary ◽

10.1007/s11102-013-0516-y ◽

2013 ◽

Vol 17 (5) ◽

pp. 414-422 ◽

Cited By ~ 10

Author(s):

Renzo Manara ◽

Joseph Gabrieli ◽

Valentina Citton ◽

Filippo Ceccato ◽

Silvia Rizzati ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Quantitative Magnetic Resonance

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Quantitative Magnetic Resonance Angiography in Internal Carotid Artery Occlusion with Primary Collateral Pathway

Journal of Stroke ◽

10.5853/jos.2015.17.3.320 ◽

2015 ◽

Vol 17 (3) ◽

pp. 320-326 ◽

Cited By ~ 5

Author(s):

Yun Jung Bae ◽

Cheolkyu Jung ◽

Jae Hyoung Kim ◽

Byung Se Choi ◽

Eunhee Kim

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Artery Occlusion ◽

Carotid Artery Occlusion ◽

Internal Carotid Artery Occlusion ◽

Quantitative Magnetic Resonance ◽

Collateral Pathway

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Abstract 122: Transit Time on Digital Subtraction Angiography Correlates with Cerebral Arteriovenous Malformation Flow Measured by Quantitative Magnetic Resonance Angiography

Stroke ◽

10.1161/str.48.suppl_1.122 ◽

2017 ◽

Vol 48 (suppl_1) ◽

Author(s):

Denise Brunozzi ◽

Ahmed E Hussein ◽

Sophia F Shakur ◽

Andreas Linninger ◽

Chih-Yang Hsu ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Digital Subtraction Angiography ◽

Transit Time ◽

Digital Subtraction ◽

Total Flow ◽

Deep Drainage ◽

Quantitative Magnetic Resonance ◽

Architectural Features ◽

Arterial Ectasia

Introduction: Digital subtraction angiography (DSA) currently provides angioarchitectural features of cerebral arteriovenous malformations (AVMs) but its role in the hemodynamic evaluation of AVMs is poorly understood. Here, we assess transit time (TT) of contrast on DSA relative to AVM flow measured using quantitative magnetic resonance angiography (QMRA). Methods: Patients seen at our institution between 2007 and 2014 with a cerebral AVM and DSA and QMRA obtained prior to any treatment were retrospectively reviewed. TT on DSA was defined as time needed for contrast to change image intensity from 10%-100%, 100%-10%, and 25%-25%. TT was correlated to AVM total flow and angio-architectural features. Results: 33 patients (mean age 34.8 years) were included. 7 patients presented with hemorrhage. Mean AVM volume was 13.61 mL (range 0.28-84.2 mL). Higher total flow significantly correlated with shorter TT100%-10% and TT25%-25% (P=0.04, P=0.03, respectively). Total flow was also significantly related to the ratio sum of draining vein diameters/TT (TT10%-100% P=0.04, TT100%-10% P=0.01, TT25%-25% P=0.02). Presence of venous stenosis (P=0.01) and arterial ectasia (P=0.03) correlated significantly with TT100%-10%. TT was not significantly related to hemorrhagic presentation, deep drainage, single draining vein, or Spetzler-Martin grade. Conclusions: TT and the ratio sum of draining vein diameters/TT correlated significantly with AVM total flow measured using QMRA, and so TT along with venous diameters determined from DSA may be used as a surrogate for AVM flow.

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Continued Concern About Parent Vessel Steno-Occlusive Progression With Onyx HD-500 and the Utility of Quantitative Magnetic Resonance Imaging in Serial Assessment

Neurosurgery ◽

10.1227/neu.0b013e31828048a3 ◽

2012 ◽

Vol 72 (3) ◽

pp. 341-352 ◽

Cited By ~ 6

Author(s):

Andrew P. Carlson ◽

Ali Alaraj ◽

Sepideh Amin-Hanjani ◽

Fady Charbel ◽

Victor Aletich

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid ◽

Parent Vessel ◽

Quantitative Magnetic Resonance ◽

Fourth Patient ◽

Aneurysm Embolization

Abstract BACKGROUND: Onyx HD-500 is a liquid embolic used to treat intracranial aneurysms. OBJECTIVE: To determine the incidence of parent vessel stenosis and the management strategy for these patients. METHODS: Medical records of patients treated with Onyx HD-500 between 2008 and 2011 were retrospectively reviewed. Clinical and radiographic evaluations were assessed. Quantitative magnetic resonance angiography and NOVA (VasSol, Chicago, Illinois) images were reviewed for patients in whom these examinations were acquired. RESULTS: Seventeen patients underwent treatment of unruptured internal carotid artery aneurysms. Three patients (17.6%) developed visual symptoms after the procedure: 2 permanent and 1 transient. Four patients (23.5%) developed delayed internal carotid artery stenosis at the 6- to 8-month follow-up angiography, despite a standard antiplatelet regimen with confirmed sensitivities to aspirin and clopidogrel. Quantitative magnetic resonance angiography was obtained in all patients with stenosis to guide treatment. One patient progressed to complete but asymptomatic internal carotid artery occlusion. The second and third patients had asymptomatic stenosis of 40% and 70%, respectively, both of which resolved on follow-up angiography. The fourth patient developed critical stenosis distal to the aneurysm neck. Quantitative magnetic resonance angiography demonstrated adequate flow in the first 3 patients and decreased flow in the fourth patient, necessitating angioplasty and stenting. Prolonged dual antiplatelet regimens were continued in 2 of the 4 patients, 1 with progression of stenosis and 1 with improvement of stenosis. CONCLUSION: We observed a higher rate of parent vessel steno-occlusive progression after aneurysm embolization with Onyx HD-500 than reported in the literature, despite overall low morbidity. Quantitative vessel flow imaging was useful in subsequent medical management and decision making to perform therapeutic angioplasty/stenting to preserve flow.

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Evaluation of extracranial–intracranial bypass using quantitative magnetic resonance angiography

Yearbook of Neurology and Neurosurgery ◽

10.1016/s0513-5117(08)79156-7 ◽

2008 ◽

Vol 2008 ◽

pp. 226-227

Author(s):

D.H. Kim

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Quantitative Magnetic Resonance

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Symmetry, asymmetry and hypoplasia of the intracranial internal carotid artery on magnetic resonance angiography

Acta Medica Academica ◽

10.5644/ama2006-124.150 ◽

2016 ◽

Vol 45 (1) ◽

pp. 1-9 ◽

Cited By ~ 2

Author(s):

Svjetlana Mujagić

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Internal Carotid

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Bilateral Internal Carotid to Anterior Cerebral Artery Anastomosis with Anterior Communicating Artery Aneurysm: Technical Case Report

Operative Neurosurgery ◽

10.1227/01.neu.0000176852.33587.e9 ◽

2005 ◽

Vol 57 (suppl_4) ◽

pp. ONS-E400-ONS-E400 ◽

Cited By ~ 2

Author(s):

Kaya Kılıç ◽

Metin Orakdöğen ◽

Aram Bakırcı ◽

Zafer Berkman

Keyword(s):

Case Report ◽

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Carotid Artery ◽

Internal Carotid Artery ◽

Cerebral Artery ◽

Internal Carotid ◽

Anterior Cerebral Artery ◽

Artery Aneurysm ◽

Anterior Communicating Artery

Abstract OBJECTIVE AND IMPORTANCE: The present case report is the first one to report a bilateral anastomotic artery between the internal carotid artery and the anterior communicating artery in the presence of a bilateral A1 segment, fenestrated anterior communicating artery (AComA), and associated aneurysm of the AComA, which was discovered by magnetic resonance angiography and treated surgically. CLINICAL PRESENTATION: A 38-year-old man who was previously in good health experienced a sudden onset of nuchal headache, vomiting, and confusion. Computed tomography revealed a subarachnoid hemorrhage. Magnetic resonance angiography and four-vessel angiography documented an aneurysm of the AComA and two anastomotic vessels of common origin with the ophthalmic artery, between the internal carotid artery and AComA. INTERVENTION: A fenestrated clip, introduced by a left pterional craniotomy, leaving in its loop the left A1 segment, sparing the perforating and hypothalamic arteries, excluded the aneurysm. CONCLUSION: The postoperative course was uneventful, with complete recovery. Follow-up angiograms documented the successful exclusion of the aneurysm. Defining this particular internal carotid-anterior cerebral artery anastomosis as an infraoptic anterior cerebral artery is not appropriate because there is already an A1 segment in its habitual localization. Therefore, it is also thought that, embryologically, this anomaly is not a misplaced A1 segment but the persistence of an embryological vessel such as the variation of the primitive prechiasmatic arterial anastomosis. The favorable outcome for our patient suggests that surgical treatment may be appropriate for many patients with this anomaly because it provides a complete and definitive occlusion of the aneurysm.

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Is there any association between jugular venous reflux and nonpulsatile subjective tinnitus? A preliminary study of four-dimensional magnetic resonance angiography

Nigerian Journal of Clinical Practice ◽

10.4103/njcp.njcp_128_19 ◽

2019 ◽

Vol 22 (10) ◽

pp. 1430

Author(s):

D Temirbekov ◽

D Yildirim ◽

D Alis ◽

S Turkmen ◽

A Bakir ◽

...

Keyword(s):

Magnetic Resonance ◽

Magnetic Resonance Angiography ◽

Venous Reflux ◽

Subjective Tinnitus ◽

Preliminary Study ◽

Jugular Venous Reflux

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Improved brain perfusion after electrical cardioversion of atrial fibrillation

EP Europace ◽

10.1093/europace/euz336 ◽

2019 ◽

Vol 22 (4) ◽

pp. 530-537 ◽

Cited By ~ 3

Author(s):

Marianna Gardarsdottir ◽

Sigurdur Sigurdsson ◽

Thor Aspelund ◽

Valdis Anna Gardarsdottir ◽

Lars Forsberg ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Atrial Fibrillation ◽

Blood Flow ◽

Cerebral Blood Flow ◽

Magnetic Resonance ◽

Brain Perfusion ◽

Resonance Imaging ◽

Flow Measurements ◽

Before And After ◽

Blood Flow Measurements

Abstract Aims Atrial fibrillation (AF) has been associated with reduced brain volume, cognitive impairment, and reduced cerebral blood flow. The causes of reduced cerebral blood flow in AF are unknown, but no reduction was seen in individuals without the arrhythmia in a previous study. The aim of this study was to test the hypothesis that brain perfusion, measured with magnetic resonance imaging (MRI), improves after cardioversion of AF to sinus rhythm (SR). Methods and results All patients undergoing elective cardioversion at our institution were invited to participate. A total of 44 individuals were included. Magnetic resonance imaging studies were done before and after cardioversion with both brain perfusion and cerebral blood flow measurements. However, 17 did not complete the second MRI as they had a recurrence of AF during the observation period (recurrent AF group), leaving 17 in the SR group and 10 in the AF group to complete both measurements. Brain perfusion increased after cardioversion to SR by 4.9 mL/100 g/min in the whole brain (P < 0.001) and by 5.6 mL/100 g/min in grey matter (P < 0.001). Cerebral blood flow increased by 58.6 mL/min (P < 0.05). Both brain perfusion and cerebral blood flow remained unchanged when cardioversion was unsuccessful. Conclusion In this study of individuals undergoing elective cardioversion for AF, restoration, and maintenance of SR for at least 10 weeks after was associated with an improvement of brain perfusion and cerebral blood flow measured by both arterial spin labelling and phase contrast MRI. In those individuals where cardioversion was unsuccessful, there was no change in perfusion or blood flow.

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