X Leclerc1,2, O Guillaud3, N Reyns3,4, J Hodel5, O Outteryck3,2, F Bala3, N Bricout3, M Bretzner3, N Ramdane5, J-P Pruvo3,2, L Hacein-Bey6, G Kuchcinski3,2. 1. From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France xavier.leclerc@chru-lille.fr. 2. Inserm U1171, Degenerative and Vascular Cognitive Disorders (X.L., O.O., J.-P.P., G.K.), University of Lille, Lille, France. 3. From the Departments of Neuroradiology (X.L., O.G., O.O., F.B., N.B., M.B., J.-P.P., G.K.), Neurosurgery (N. Reyns), Neurology (O.O.), Centre Hospitalier Universitaire Lille, Lille, France. 4. Inserm U1189-ONCO-THAI-Image Assisted Laser Therapy for Oncology (N. Reyns), University of Lille, Lille, France. 5. Department of Neuroradiology (J.H.), Hôpital Henri Mondor, Créteil, France; EA 2694-Public Health: Epidemiology and Quality of Care (N. Ramdane), University of Lille, Centre Hospitalier Universitaire Lille, Lille, France. 6. Neuroradiology, Radiology Department (L.H.-B.), University of California Davis School of Medicine, Sacramento, California.
Abstract
BACKGROUND AND PURPOSE: Follow-up MR imaging of brain AVMs currently relies on contrast-enhanced sequences. Noncontrast techniques, including arterial spin-labeling and TOF, may have value in detecting a residual nidus after radiosurgery. The aim of this study was to compare noncontrast with contrast-enhanced MR imaging for the differentiation of residual-versus-obliterated brain AVMs in radiosurgically treated patients. MATERIALS AND METHODS: Twenty-eight consecutive patients with small brain AVMs (<20 mm) treated by radiosurgery were followed with the same MR imaging protocol. Three neuroradiologists, blinded to the results, independently reviewed the following: 1) postcontrast images alone (4D contrast-enhanced MRA and postcontrast 3D T1 gradient recalled-echo), 2) arterial spin-labeling and TOF images alone, and 3) all MR images combined. The primary end point was the detection of residual brain AVMs using a 5-point scale, with DSA as the reference standard. RESULTS: The highest interobserver agreement was for arterial spin-labeling/TOF (κ = 0.81; 95% confidence interval, 0.66-0.93). Regarding brain AVM detection, arterial spin-labeling/TOF had higher sensitivity (sensitivity, 85%; specificity, 100%; 95% CI, 62-97) than contrast-enhanced MR imaging (sensitivity, 55%; specificity, 100%; 95% CI, 27-73) and all MR images combined (sensitivity, 75%; specificity, 100%; 95% CI, 51-91) (P = .008). All nidus obliterations on DSA were detected on MR imaging. In 6 patients, a residual brain AVM present on DSA was only detected with arterial spin-labeling/TOF, including 3 based solely on arterial spin-labeling images. CONCLUSIONS: In this study of radiosurgically treated patients with small brain AVMs, arterial spin-labeling/TOF was found to be superior to gadolinium-enhanced MR imaging in detecting residual AVMs.
BACKGROUND AND PURPOSE: Follow-up MR imaging of brain AVMs currently relies on contrast-enhanced sequences. Noncontrast techniques, including arterial spin-labeling and TOF, may have value in detecting a residual nidus after radiosurgery. The aim of this study was to compare noncontrast with contrast-enhanced MR imaging for the differentiation of residual-versus-obliterated brain AVMs in radiosurgically treated patients. MATERIALS AND METHODS: Twenty-eight consecutive patients with small brain AVMs (<20 mm) treated by radiosurgery were followed with the same MR imaging protocol. Three neuroradiologists, blinded to the results, independently reviewed the following: 1) postcontrast images alone (4D contrast-enhanced MRA and postcontrast 3D T1 gradient recalled-echo), 2) arterial spin-labeling and TOF images alone, and 3) all MR images combined. The primary end point was the detection of residual brain AVMs using a 5-point scale, with DSA as the reference standard. RESULTS: The highest interobserver agreement was for arterial spin-labeling/TOF (κ = 0.81; 95% confidence interval, 0.66-0.93). Regarding brain AVM detection, arterial spin-labeling/TOF had higher sensitivity (sensitivity, 85%; specificity, 100%; 95% CI, 62-97) than contrast-enhanced MR imaging (sensitivity, 55%; specificity, 100%; 95% CI, 27-73) and all MR images combined (sensitivity, 75%; specificity, 100%; 95% CI, 51-91) (P = .008). All nidus obliterations on DSA were detected on MR imaging. In 6 patients, a residual brain AVM present on DSA was only detected with arterial spin-labeling/TOF, including 3 based solely on arterial spin-labeling images. CONCLUSIONS: In this study of radiosurgically treated patients with small brain AVMs, arterial spin-labeling/TOF was found to be superior to gadolinium-enhanced MR imaging in detecting residual AVMs.
Authors: D R Buis; J C J Bot; F Barkhof; D L Knol; F J Lagerwaard; B J Slotman; W P Vandertop; R van den Berg Journal: AJNR Am J Neuroradiol Date: 2011-11-17 Impact factor: 3.825
Authors: J Hodel; X Leclerc; E Kalsoum; M Zuber; R Tamazyan; M A Benadjaoud; J-P Pruvo; M Piotin; H Baharvahdat; M Zins; R Blanc Journal: AJNR Am J Neuroradiol Date: 2016-10-27 Impact factor: 3.825
Authors: Dariusch R Hadizadeh; Marcus von Falkenhausen; Jürgen Gieseke; Bernhard Meyer; Horst Urbach; Romhild Hoogeveen; Hans H Schild; Winfried A Willinek Journal: Radiology Date: 2007-10-19 Impact factor: 11.105
Authors: Robert A Willinsky; Steve M Taylor; Karel TerBrugge; Richard I Farb; George Tomlinson; Walter Montanera Journal: Radiology Date: 2003-03-13 Impact factor: 11.105