Utility of silent magnetic resonance angiography in the evaluation and characterisation of intracranial dural arteriovenous fistula

Balasubramanian, Arun Prasad; Kannath, Santhosh Kumar; Rajan, Jayadevan Enakshy; Singh, Gurjit; Kesavadas, C.

doi:10.1016/j.crad.2021.05.008

Cited by 7 publications

(7 citation statements)

References 19 publications

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“…Nevertheless, MRA is an easy and convenient modality for screening DAVF because DSA is an invasive examination. 14 ) However, in rare cases such as the present case, or when the shunt is faint, it may be difficult to make a diagnosis due to poor imaging. In fact, Yu-Ching et al reported that only 63.4% of cases diagnosed as DAVF by DSA could be diagnosed by TOF-MRA.…”

Section: Discussionmentioning

confidence: 79%

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Dural Arteriovenous Fistula Mimicking a Brain Tumor on Methionine-positron Emission Tomography: A Case Report

HANYU

Nishihori

Izumi

et al. 2022

NMC Case Report Journal

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In this article, we report a case wherein a brain tumor was suspected based on computed tomography and magnetic resonance imaging findings. We made an initial diagnosis of malignant brain tumor based on methionine-positron emission tomography (PET) findings, but the correct diagnosis was dural arteriovenous fistula (DAVF). The patient was a 45-year-old man with DAVF who developed headache. Methionine-PET imaging showed high methionine uptake in the lesion. Although the tumor was strongly suspected from the findings of methionine-PET, the diagnosis of DAVF could be made correctly only by interpreting digital subtraction angiography and computed tomographic angiography. The findings of methionine-PET, which is considered useful in the diagnosis and denial of brain tumors, made the diagnosis of DAVF more difficult. The increased uptake of methionine-PET in DAVF is an important finding because, to our knowledge, this study is the first to report such finding. The results of this study might be useful for differential diagnoses when the diagnosis is uncertain.

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Section: Discussionmentioning

confidence: 79%

“…Nevertheless, MRA is an easy and convenient modality for screening DAVF because DSA is an invasive examination. 14) NMC Case Report Journal Vol. 9, 2022 However, in rare cases such as the present case, or when the shunt is faint, it may be difficult to make a diagnosis due to poor imaging.…”

Section: Diagnostics Of Davfmentioning

confidence: 99%

Dural Arteriovenous Fistula Mimicking a Brain Tumor on Methionine-positron Emission Tomography: A Case Report

HANYU

Nishihori

Izumi

et al. 2022

NMC Case Report Journal

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“…These differences may arise from the low spatial resolution (1.2 mm) and marginal artifact in mid to distal branches of the circle of Willis for silent MRA. The voxel size of 1.2×1.2×1.2 mm is one of the mainstream settings of silent scan for cerebrovascular disease in current studies, taking both signal-to-noise ratio and scan time into account 7 9–11. When voxel size is reduced to 1 mm, the scan time is prolonged for more than 12 min 21.…”

Section: Discussionmentioning

confidence: 99%

“…In addition to sound reduction, silent MRA outperformed time-of-flight MRA (TOF-MRA) in visualizing flow in a small diameter, slow-flow, multidirectional flow, whirlpools, turbulent flow blood vessels, and flowing blood in stents or residual space in aneurysms after coiling 7. Consequently, silent MRA has been proven to better visualize unruptured aneurysms, Moyamoya vessels, brain arteriovenous malformations, intracranial dural arteriovenous fistulas, and follow-up after endovascular treatment of cerebral aneurysms than TOF-MRA 8–11. However, to date, the ability of silent MRA to reliably assess the three-dimensional (3D) morphology and hemodynamics of IAs remains unclear.…”

Section: Introductionmentioning

confidence: 99%

Non-contrast enhanced silent MR angiography to evaluate hemodynamics and morphology of unruptured intracranial aneurysms: a comparative computational fluid dynamics study

Leng²,

Zou³

et al. 2022

J NeuroIntervent Surg

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BackgroundSilent MR angiography (silent MRA) is a new generation of non-contrast enhanced angiography with outstanding advantages in visualizing cerebrovascular lesions and the follow-up after endovascular treatment for intracranial aneurysms (IAs). This study aims to investigate the reliability of silent MRA-based three-dimensional (3D) geometric description and hemodynamic calculation of IAs.Methods19 patients with 23 unruptured IAs, who underwent both silent MRA and 3D rotational angiography (3DRA), were included in this study. Computational fluid dynamics simulations were performed on all patient-specific 3D reconstruction images to compare the morphology and hemodynamics of the two different imaging models for IAs.ResultsSilent MRA models had smaller maximum and perpendicular height (mm), aneurysmal surface area (mm2), and aneurysmal volume (mm3) than 3DRA (p<0.05); the differences of the above parameters between the two models were 9.0±6.2%, 7.7±7.4%, 15.9±13.0%, and 21.4±17.5%, respectively. However, correlation analysis of morphological parameters in various dimensions and model comparison showed good overall consistency in geometrical characteristics between the two models. Moderate coherence was observed between models in time-averaged wall shear stress of aneurysm and parent vessel (TAWSS, PAWSS), aneurysm velocity (AV), parent vessel velocity, and oscillatory shear index (OSI). However, strong correlations were observed among normalized aneurysm wall shear stress (NWSS), low shear area (LSA), inflow concentration index (ICI), and normalized aneurysm velocity (NAV).ConclusionBoth morphological and hemodynamic assessments of IAs for silent MRA are comparable to 3DRA. Additionally, normalized indicators such as NWSS, LSA, ICI, and NAV were better than TAWSS, AV, and OSI in silent MRA-related hemodynamic evaluation.

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“…Therefore, a non-invasive, reliable imaging modality that characterizes CSDAVF is beneficial for the triaging of these patients and assessing the resolution on follow-up. There are only a few studies on the utility of advanced magnetic resonance angiography (MRA) techniques like 3D time-of-flight (TOF) MRA and susceptibility-weighted imaging (SWI) with DSA for the evaluation of cranial dural arteriovenous fistulas (dAVF), but none for CSDAVF (1,4). Silent MRA is a recently introduced non-contrast MRA technique that employs ultrashort echo time (TE = 0.016 ms) and arterial spin labelling (ASL) methods to obtain angiographic images.…”

Section: Introductionmentioning

confidence: 99%

Non-invasive angiographic analysis of dural carotid cavernous fistula using time-of-flight MR angiography and silent MR angiography: a comparative study

et al. 2022

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Background A non-invasive, reliable imaging modality that characterizes cavernous sinus dural arteriovenous fistula (CSDAVF) is beneficial for diagnosis and to assess resolution on follow-up. Purpose To assess the utility of 3D time-of-flight (TOF) and silent magnetic resonance angiography (MRA) for evaluation of CSDAVF from an endovascular perspective. Material and Methods This prospective study included 37 patients with CSDAVF, who were subjected to digital subtraction angiography (DSA) and 3-T MR imaging with 3D TOF and silent MRA. The main arterial feeders, fistula site, and venous drainage pattern were evaluated, and the results were compared with DSA findings. The diagnostic confidence scores were also recorded using a 4-point Likert scale. Results Silent MRA correlated better for shunt site localization and angiographic classification (86% vs. 75% and 83% vs. 75%, respectively) compared to TOF MRA. The proportion of arterial feeders detected was marginally significant for silent MRA over TOF MRA sequences (92.8% vs. 89.5%; P=0.048), though for veins both were comparable. Sensitivity of silent MRA was higher for identification of cortical venous reflux (CVR) (90.9% vs. 81.8%) and deep venous drainage (82.4% vs. 64.7%), while specificity was >90% for both modalities. The overall diagnostic confidence score fared better for silent MRA for venous assessment ( P < 0.001) as well as fistula point identification ( P < 0.001), while no significant difference was evident with TOF MRA for arterial feeders ( P=0.06). Conclusion Various angiographic components of CSDAVF could be identified and delineated by 3D TOF and silent MRA, though silent MRA was superior for overall diagnostic assessment.

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Utility of silent magnetic resonance angiography in the evaluation and characterisation of intracranial dural arteriovenous fistula

Cited by 7 publications

References 19 publications

Dural Arteriovenous Fistula Mimicking a Brain Tumor on Methionine-positron Emission Tomography: A Case Report

Dural Arteriovenous Fistula Mimicking a Brain Tumor on Methionine-positron Emission Tomography: A Case Report

Non-contrast enhanced silent MR angiography to evaluate hemodynamics and morphology of unruptured intracranial aneurysms: a comparative computational fluid dynamics study

Non-invasive angiographic analysis of dural carotid cavernous fistula using time-of-flight MR angiography and silent MR angiography: a comparative study

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