Simone Hammer1, Wibke Uller2,3, Florentine Manger4, Claudia Fellner2, Florian Zeman5, Walter A Wohlgemuth2. 1. Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany. simone.hammer@ukr.de. 2. Department of Radiology, University Hospital Regensburg, 93042, Regensburg, Germany. 3. Division of Vascular and Interventional Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA, 02115, USA. 4. Department of Nuclear Medicine, University Hospital Würzburg, Josef-Schneider-Straße 2, 97080, Würzburg, Germany. 5. Center for Clinical Trials, University Hospital Regensburg, 93042, Regensburg, Germany.
Abstract
OBJECTIVES: Quantitative evaluation of hemodynamic characteristics of arteriovenous and venous malformations using time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla. METHODS: Time-resolved MRA with interleaved stochastic trajectories (TWIST) at 3.0 Tesla was studied in 83 consecutive patients with venous malformations (VM) and arteriovenous malformations (AVM). Enhancement characteristics were calculated as percentage increase of signal intensity above baseline over time. Maximum percentage signal intensity increase (signalmax), time intervals between onset of arterial enhancement and lesion enhancement (tonset), and time intervals between beginning of lesion enhancement and maximum percentage of lesion enhancement (tmax) were analyzed. RESULTS: All AVMs showed a high-flow hemodynamic pattern. Two significantly different (p < 0.001) types of venous malformations emerged: VMs with arteriovenous fistulas (AVF) (median signalmax 737 %, IQR [interquartile range] = 511 - 1182 %; median tonset 5 s, IQR = 5 - 10 s; median tmax 35 s, IQR = 26 - 40 s) and without AVFs (median signalmax 284 %, IQR = 177-432 %; median tonset 23 s, IQR = 15 - 30 s; median tmax 60 s, IQR = 55 - 75 s). CONCLUSIONS: Quantitative evaluation of time-resolved MRA at 3.0 Tesla provides hemodynamic characterization of vascular malformations. VMs can be subclassified into two hemodynamic subgroups due to presence or absence of AVFs. KEY POINTS: • Time-resolved MRA at 3.0 Tesla provides quantitative hemodynamic characterization of vascular malformations. • Malformations significantly differ in time courses of enhancement and signal intensity increase. • AVMs show a distinctive high-flow hemodynamic pattern. • Two significantly different types of VMs emerged: VMs with and without AVFs.
OBJECTIVES: Quantitative evaluation of hemodynamic characteristics of arteriovenous and venous malformations using time-resolved magnetic resonance angiography (MRA) at 3.0 Tesla. METHODS: Time-resolved MRA with interleaved stochastic trajectories (TWIST) at 3.0 Tesla was studied in 83 consecutive patients with venous malformations (VM) and arteriovenous malformations (AVM). Enhancement characteristics were calculated as percentage increase of signal intensity above baseline over time. Maximum percentage signal intensity increase (signalmax), time intervals between onset of arterial enhancement and lesion enhancement (tonset), and time intervals between beginning of lesion enhancement and maximum percentage of lesion enhancement (tmax) were analyzed. RESULTS: All AVMs showed a high-flow hemodynamic pattern. Two significantly different (p < 0.001) types of venous malformations emerged: VMs with arteriovenous fistulas (AVF) (median signalmax 737 %, IQR [interquartile range] = 511 - 1182 %; median tonset 5 s, IQR = 5 - 10 s; median tmax 35 s, IQR = 26 - 40 s) and without AVFs (median signalmax 284 %, IQR = 177-432 %; median tonset 23 s, IQR = 15 - 30 s; median tmax 60 s, IQR = 55 - 75 s). CONCLUSIONS: Quantitative evaluation of time-resolved MRA at 3.0 Tesla provides hemodynamic characterization of vascular malformations. VMs can be subclassified into two hemodynamic subgroups due to presence or absence of AVFs. KEY POINTS: • Time-resolved MRA at 3.0 Tesla provides quantitative hemodynamic characterization of vascular malformations. • Malformations significantly differ in time courses of enhancement and signal intensity increase. • AVMs show a distinctive high-flow hemodynamic pattern. • Two significantly different types of VMs emerged: VMs with and without AVFs.
Entities:
Keywords:
Arteriovenous fistula; Arteriovenous malformation; Magnetic resonance angiography; Magnetic resonance imaging; Vascular malformation
Authors: M Anzidei; B Cavallo Marincola; A Napoli; L Saba; F Zaccagna; P Lucatelli; F Fanelli; E Bassetti; F M Salvatori; C Catalano; R Passariello Journal: Clin Radiol Date: 2011-09-06 Impact factor: 2.350
Authors: Lucía Flors; Carlos Leiva-Salinas; Ismaeel M Maged; Patrick T Norton; Alan H Matsumoto; John F Angle; Md Hugo Bonatti; Auh Whan Park; Ehab Ali Ahmad; Ugur Bozlar; Ahmed M Housseini; Thomas E Huerta; Klaus D Hagspiel Journal: Radiographics Date: 2011 Sep-Oct Impact factor: 5.333
Authors: K M Rak; W F Yakes; R L Ray; J N Dreisbach; S H Parker; J M Luethke; A T Stavros; D D Slater; B J Burke Journal: AJR Am J Roentgenol Date: 1992-07 Impact factor: 3.959
Authors: Petrice M Mostardi; Phillip M Young; Michael A McKusick; Stephen J Riederer Journal: J Magn Reson Imaging Date: 2012-06-04 Impact factor: 4.813
Authors: Ji Hye Min; Young Kon Kim; Tae Wook Kang; Woo Kyoung Jeong; Won Jae Lee; Soohyun Ahn; Na Young Hwang Journal: Eur Radiol Date: 2018-02-15 Impact factor: 5.315
Authors: Vanessa F Schmidt; Max Masthoff; Michael Czihal; Beatrix Cucuruz; Beate Häberle; Richard Brill; Walter A Wohlgemuth; Moritz Wildgruber Journal: Mol Cell Pediatr Date: 2021-12-07