Silent MRA: arterial spin labeling magnetic resonant angiography with ultra-short time echo assessing cerebral arteriovenous malformation

Arai, Nobuhiko; Akiyama, Takahiro; Fujiwara, Kazuhiro; Koike, Kotaro; Takahashi, Satoshi; Horiguchi, Takashi; Jinzaki, Masahiro; Yoshida, Kazunari

doi:10.1007/s00234-019-02345-3

Cited by 19 publications

(22 citation statements)

References 29 publications

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“…Concordance of the angioarchitectures of AVMs and AVFs between CS-TOF, PI-TOF, and DSA was calculated with unweighted and weighted kappa statistics [13,14,25]. Table 1 summarizes the patient characteristics of analysis 1.…”

Section: Discussionmentioning

confidence: 99%

“…First, this was a retrospective study at a single center, and the number of patients was relatively small, so the results might be skewed. It should be noted that we did not included patients with micro AVM (i.e., nidus size ≦ 10 mm), which may be difficult to detect with TOF-MRA [14]. Second, analysis 1 included patients with intracranial pathologies other than AVS as controls, which represent a source of selection bias.…”

Section: Discussionmentioning

confidence: 99%

“…This may be due to the slow speed and complex directions of flow, leading to less inflow enhancement. In fact, several studies have shown the advantages of other advanced imaging techniques such as 4D-MRA, susceptibility-weighted imaging, and arterial spin labeling over TOF-MRA in the evaluation of AVS [13,14,18,25,27], at least in terms of concordance with DSA findings. These advanced sequences have specific advantages such as little effect of T1 shortening and detailed hemodynamic information.…”

Section: Discussionmentioning

confidence: 99%

“…However, this invasive technique carries a risk of neurological complications and adverse reactions associated with the contrast agent as well as the exposure to ionizing radiation during the procedure. Various non-or less-invasive imaging techniques have thus been applied to the evaluation of AVS [12][13][14][15][16][17][18][19][20][21][22]. Time-of-flight (TOF)-MRA has been the most widely used of these in clinical practice.…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of cerebral arteriovenous shunts: a comparison of parallel imaging time-of-flight magnetic resonance angiography (TOF-MRA) and compressed sensing TOF-MRA to digital subtraction angiography

et al. 2020

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Purpose Time-of-flight (TOF)-MR angiography (MRA) is an important imaging sequence for the surveillance and analysis of cerebral arteriovenous shunt (AVS), including arteriovenous malformation (AVM) and arteriovenous fistula (AVF). However, this technique has the disadvantage of a relatively long scan time. The aim of this study was to compare diagnostic accuracy between compressed sensing (CS)-TOF and conventional parallel imaging (PI)-TOF-MRA for detecting and characterizing AVS. Methods This study was approved by the institutional review board for human studies. Participants comprised 56 patients who underwent both CS-TOF-MRA and PI-TOF-MRA on a 3-T MR unit with or without cerebral AVS between June 2016 and September 2018. Imaging parameters for both sequences were almost identical, except the acceleration factor of 3× for PI-TOF-MRA and 6.5× for CS-TOF-MRA, and the scan time of 5 min 19 s for PI-TOF-MRA and 2 min 26 s for CS-TOF-MRA. Two neuroradiologists assessed the accuracy of AVS detection on each sequence and analyzed AVS angioarchitecture. Concordance between CS-TOF, PI-TOF, and digital subtraction angiography was calculated using unweighted and weighted kappa statistics. Results Both CS-TOF-MRA and PI-TOF-MRA yielded excellent sensitivity and specificity for detecting intracranial AVS (reviewer 1, 97.3%, 94.7%; reviewer 2, 100%, 100%, respectively). Interrater agreement on the angioarchitectural features of intracranial AVS on CS-MRA and PI-MRA was moderate to good. Conclusion The diagnostic performance of CS-TOF-MRA is comparable to that of PI-TOF-MRA in detecting and classifying AVS with a reduced scan time under 2.5 min.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Evaluation of cerebral arteriovenous shunts: a comparison of parallel imaging time-of-flight magnetic resonance angiography (TOF-MRA) and compressed sensing TOF-MRA to digital subtraction angiography

et al. 2020

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“…Notably, UTE-MRA reduces metal artifact, 3,[5][6][7] and its usefulness has been reported for the assessment of the internal flow in the intracranial stent, 8,9,18) moyamoya disease, 19) and arteriovenous malformation. 20,21) However, a few studies reported the usefulness of specific UTE-MRA, such as pointwise encoding time reduction with radial acquisition (PETRA 16) ; Siemens Healthcare, Erlangen, Germany) 10,11) and SILENT MRA 12,14) for the assessment of arteries and aneurysm neck remnant in the vicinity of a clip.…”

Section: Introductionmentioning

confidence: 99%

Usefulness of 3 Tesla Ultrashort Echo Time Magnetic Resonance Angiography (UTE-MRA, SILENT-MRA) for Evaluation of the Mother Vessel after Cerebral Aneurysm Clipping: Case Series of 19 Patients

Katsuki

Narita

Ishida

et al. 2021

Neurol. Med. Chir.(Tokyo)

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It is important to assess the cerebral arteries near the clip after cerebral aneurysm clipping. Contrast-enhanced computed tomography angiography has side effects of contrast medium and radiation exposure. Time-of-flight magnetic resonance angiography (TOF-MRA) is a fast and non-invasive method, but clip-induced artifact limits the assessment around the clip. Recently, 3 tesla MRA with ultrashort echo time called SILENT MRA (GE Healthcare Life Sciences, UK) has been reported to have the potential to overcome these disadvantages. We herein present consecutive 19 cerebral aneurysm patients treated by clipping and evaluated using SILENT MRA. The 19 patients (15 women and 4 men) underwent TOF-MRA and SILENT MRA during the same scan session. Two neurosurgeons independently assessed the visibility of the mother vessel at the clipping site in TOF-MRA and SILENT MRA. We also investigated the factors related to visibility in SILENT MRA. All patients' mother vessels were not described in TOF-MRA, and that of 16 patients (84%) were described in SILENT MRA. Overall agreement was 100% in the two neurosurgeons, and the fixed marginal kappa = 1.00 (95% CI: 0.36-1.00). Univariate analysis revealed that larger aneurysm dome and long clip blade length contributed to the visibility of the mother vessel in SILENT MRA. (p = 0.023, 0.007, each). In conclusion, SILENT MRA can be applied for the assessment of the arteries and aneurysm neck remnants near the clip. Using clips with long blade and ligation with its tip would be related to the visibility of the mother vessels in SILENT MRA.

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Can Arterial Spin Labeling Perfusion Imaging be Used to Differentiate Nasopharyngeal Carcinoma From Nasopharyngeal Lymphoma?

Sun

Jin

et al. 2020

Magnetic Resonance Imaging

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Background Differentiating nasopharyngeal carcinoma (NPC) from nasopharyngeal lymphoma (NPL) is useful for deciding the appropriate treatment. However, the diagnostic accuracy of current imaging methods is low. Purpose To explore the feasibility of arterial spin labeling (ASL) perfusion imaging in the qualitative and quantitative differentiation between NPC and NPL to improve the diagnosis of malignancies in the nasopharynx. Study Type Retrospective. Population Ninety seven patients: NPC (65 cases) and NPL (32 cases), histologically confirmed. Field Strength/Sequence 3T/3D fast spin echo pseudo‐continuous ASL imaging with spiral readout scheme, 3D inverse recovery–fast spoiled gradient recalled echo brain volume (BRAVO) imaging. Assessment Cerebral blood flow (CBF) images from ASL perfusion imaging were assessed by three radiologists. Each tumor was visually scored based on CBF images. Intratumoral CBF and intramuscular CBF values were obtained from intratumoral and lateral pterygoid muscle areas, respectively. Through dividing intratumoral CBF by intramuscular CBF, normalized CBF (nCBF) was further calculated. Statistical Tests Fleiss's kappa and intraclass correlation coefficients (ICCs) were used to assess interobserver agreement among the three readers. The Mann–Whitney U‐test was used to compare visual scoring, and an unpaired t‐test was performed to compare CBF value between the NPC and NPL groups. The area under the curve (AUC) value was used to quantify the diagnostic ability of each parameter. Results Good interobserver agreements were validated by high Fleiss's kappa and ICC values (all >0.80). NPCs showed significantly higher visual scores than NPLs (P < 0.05). Both intratumoral CBF and nCBF in NPC were significantly higher than those in NPL (both P < 0.05). Intratumoral CBF showed the highest AUC of 0.861 (P < 0.05) in differentiating NPC (n = 65) from NPL (n = 32), while the AUCs of nCBF and visual scoring were 0.847 and 0.753, respectively. Data Conclusion For the diagnosis of distinguishing NPC from NPL, ASL perfusion imaging demonstrated high diagnostic efficiency. Level of Evidence 3 Technical Efficacy Stage 2

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Silent MRA: arterial spin labeling magnetic resonant angiography with ultra-short time echo assessing cerebral arteriovenous malformation

Cited by 19 publications

References 29 publications

Evaluation of cerebral arteriovenous shunts: a comparison of parallel imaging time-of-flight magnetic resonance angiography (TOF-MRA) and compressed sensing TOF-MRA to digital subtraction angiography

Evaluation of cerebral arteriovenous shunts: a comparison of parallel imaging time-of-flight magnetic resonance angiography (TOF-MRA) and compressed sensing TOF-MRA to digital subtraction angiography

Usefulness of 3 Tesla Ultrashort Echo Time Magnetic Resonance Angiography (UTE-MRA, SILENT-MRA) for Evaluation of the Mother Vessel after Cerebral Aneurysm Clipping: Case Series of 19 Patients

Can Arterial Spin Labeling Perfusion Imaging be Used to Differentiate Nasopharyngeal Carcinoma From Nasopharyngeal Lymphoma?

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