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Samp PF, Keil F, du Mesnil R, Birkhold A, Kowarschik M, Hattingen E, Berkefeld J. 4D-DSA for Assessment of the Angioarchitecture and Grading of Cranial Dural AVF. AJNR Am J Neuroradiol 2023; 44:1291-1295. [PMID: 37827722 PMCID: PMC10631524 DOI: 10.3174/ajnr.a8008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/30/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND AND PURPOSE Time-resolved 3D rotational angiography (4D-DSA) has been used to demonstrate details of the angioarchitecture of AVM, whereas it has rarely been used to describe features of dural AVF. In this exploratory study, we analyzed dural AVFs with a novel 4D software prototype, developed and provided by Siemens, to determine whether identification of the location of the fistulous point, grading, and treatment planning were feasible. MATERIALS AND METHODS 4D-DSA volumes were calculated from existing 3D rotational angiography data sets of patients with dural AVFs. The 4D-DSA volumes were displayed in a virtual DSA mode and MPR or MIP in 3 orthogonal planes and compared with 2D-DSA by 2 experienced neuroradiologists. Fusions with unenhanced CT or MR images were used to improve visualization of adjacent anatomic structures. RESULTS Comparison with 2D-DSA showed that evaluation of the fistulous point and grading according to the classification of Borden, Cognard, or Barrow was feasible in 26 of 27 cases. In 8 of 27 cases, 4D-DSA was considered advantageous for determining the fistulous point and the course of the draining vein in the dural AVF with cortical venous drainage, especially in the frontoethmoidal and frontoparietal regions. In 6 cases, the display of angioarchitecture was considered inferior to that of 2D-DSA due to motion artifacts, suboptimal selection of the injected vessel, and lack of temporal resolution. CONCLUSIONS Detailed analysis of dural AVFs according to the standardized display of 4D-DSA volumes was feasible and helpful in understanding the angioarchitecture in selected cases. Further improvement and validation of the 4D software should solidify the complementary role of 4D-DSA to conventional 2D-DSA series.
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Affiliation(s)
- P F Samp
- From the Institute of Neuroradiology (P.F.S., F.K., R.d.M., E.H., J.B.), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - F Keil
- From the Institute of Neuroradiology (P.F.S., F.K., R.d.M., E.H., J.B.), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - R du Mesnil
- From the Institute of Neuroradiology (P.F.S., F.K., R.d.M., E.H., J.B.), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - A Birkhold
- Siemens Healthcare (A.B., M.K.), Forchheim, Germany
| | - M Kowarschik
- Siemens Healthcare (A.B., M.K.), Forchheim, Germany
| | - E Hattingen
- From the Institute of Neuroradiology (P.F.S., F.K., R.d.M., E.H., J.B.), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
| | - J Berkefeld
- From the Institute of Neuroradiology (P.F.S., F.K., R.d.M., E.H., J.B.), University Hospital Frankfurt, Goethe University Frankfurt, Frankfurt am Main, Germany
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Roumi A, Ben Hassen W, Hmeydia G, Posener S, Pallud J, Sharshar T, Calvet D, Mas JL, Baron JC, Oppenheim C, Naggara O, Turc G. Diagnostic performance of dynamic 3D magnetic resonance angiography in daily practice for the detection of intracranial arteriovenous shunts in patients with non-traumatic intracranial hemorrhage. Front Neurol 2023; 13:1085806. [PMID: 36776575 PMCID: PMC9911434 DOI: 10.3389/fneur.2022.1085806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/19/2022] [Indexed: 01/28/2023] Open
Abstract
Introduction Identification of treatable causes of intracranial hemorrhage (ICH) such as intracranial arteriovenous shunt is crucial to prevent recurrence. However, diagnostic approaches vary considerably across centers, partly because of limited knowledge of the diagnostic performance of first-line vascular imaging techniques. We assessed the diagnostic performance of dynamic three-dimensional magnetic resonance angiography (dynamic 3D MRA) in daily practice to detect intracranial arteriovenous shunts in ICH patients against subsequent digital subtraction angiography (DSA) as reference standard. Methods We reviewed all adult patients who underwent first-line dynamic 3D MRA and subsequent DSA for non-traumatic ICH between January 2016 and September 2021 in a tertiary center. Sensitivity, specificity, accuracy, positive and negative predictive values of dynamic 3D MRA for the detection of intracranial arteriovenous shunt were calculated with DSA as reference standard. Results Among 104 included patients, 29 (27.9%) had a DSA-confirmed arteriovenous shunt [19 pial arteriovenous malformations, 10 dural arteriovenous fistulae; median onset-to-DSA: 17 (IQR: 3-88) days]. The sensitivity and specificity of dynamic 3D MRA [median onset-to-dynamic 3D MRA: 14 (3-101) h] for the detection of intracranial arteriovenous shunt were 66% (95% CI: 48-83) and 91% (95% CI: 84-97), respectively. The corresponding accuracy, positive and negative predictive values were 84% (95% CI: 77-91), 73% (95% CI: 56-90), and 87% (95% CI: 80-95), respectively. Conclusion This study suggests that although first-line evaluation with dynamic 3D MRA may be helpful for the detection of intracranial arteriovenous shunts in patients with ICH, additional vascular imaging work-up should not be withheld if dynamic 3D MRA is negative. Comparative prospective studies are needed to determine the best imaging strategy to diagnose arteriovenous shunts after non-traumatic ICH.
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Affiliation(s)
- Arnaud Roumi
- Neurology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Wagih Ben Hassen
- Neuroradiology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Ghazi Hmeydia
- Neuroradiology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Sacha Posener
- Neurology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Johan Pallud
- Neurosurgery Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Tarek Sharshar
- Neuro-Intensive Care Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - David Calvet
- Neurology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Jean-Louis Mas
- Neurology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Jean-Claude Baron
- Neurology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Catherine Oppenheim
- Neuroradiology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Olivier Naggara
- Neuroradiology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France
| | - Guillaume Turc
- Neurology Department, GHU Paris Psychiatrie et Neurosciences, Institut de Psychiatrie et Neurosciences de Paris, INSERM U1266, Université Paris Cité, FHU Neurovasc, Paris, France,*Correspondence: Guillaume Turc ✉
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Altenbernd JC, Fischer S, Scharbrodt W, Schimrigk S, Eyding J, Nordmeyer H, Wohlert C, Dörner N, Li Y, Wrede K, Pierscianek D, Köhrmann M, Frank B, Forsting M, Deuschl C. CT and DSA for evaluation of spontaneous intracerebral lobar bleedings. Front Neurol 2022; 13:956888. [PMID: 36262835 PMCID: PMC9574012 DOI: 10.3389/fneur.2022.956888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 08/12/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose This study retrospectively examined the extent to which computed tomography angiography (CTA) and digital subtraction angiography (DSA) can help identify the cause of lobar intracerebral bleeding. Materials and methods In the period from 2002 to 2020, data from patients who were >18 years at a university and an academic teaching hospital with lobar intracerebral bleeding were evaluated retrospectively. The CTA DSA data were reviewed separately by two neuroradiologists, and differences in opinion were resolved by consensus after discussion. A positive finding was defined as an underlying vascular etiology of lobar bleeding. Results The data of 412 patients were retrospectively investigated. DSA detected a macrovascular cause of bleeding in 125/412 patients (33%). In total, sixty patients had AVMs (15%), 30 patients with aneurysms (7%), 12 patients with vasculitis (3%), and 23 patients with dural fistulas (6%). The sensitivity, specificity, positive and negative predictive values, and accuracy of CTA compared with DSA were 93, 97, 100, and 97%. There were false-negative CTA readings for two AVMs and one dural fistula. Conclusion The DSA is still the gold standard diagnostic modality for detecting macrovascular causes of ICH; however, most patients with lobar ICH can be investigated first with CTA, and the cause of bleeding can be found. Our results showed higher sensitivity and specificity than those of other CTA studies.
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Affiliation(s)
- Jens-Christian Altenbernd
- Department of Radiology, Gemeinschaftskrankenhaus, Herdecke, Germany
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
- *Correspondence: Jens-Christian Altenbernd
| | | | | | | | - Jens Eyding
- Department of Neurology, Gemeinschaftskrankenhaus, Herdecke, Germany
| | | | - Christine Wohlert
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Nils Dörner
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Yan Li
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Karsten Wrede
- Department of Neurosurgery, University Hospital Essen, Essen, Germany
| | | | - Martin Köhrmann
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Benedikt Frank
- Department of Neurology, University Hospital Essen, Essen, Germany
| | - Michael Forsting
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
| | - Cornelius Deuschl
- Institute of Diagnostic and Interventional Radiology and Neuroradiology, University Hospital Essen, Essen, Germany
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Huang W, Gao W, Hou C, Zhang X, Wang X, Zhang J. Simultaneous vessel segmentation and unenhanced prediction using self-supervised dual-task learning in 3D CTA (SVSUP). COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 224:107001. [PMID: 35810508 DOI: 10.1016/j.cmpb.2022.107001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 06/05/2022] [Accepted: 07/01/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND AND OBJECTIVE The vessel segmentation in CT angiography (CTA) provides an important basis for automatic diagnosis and hemodynamics analysis. Virtual unenhanced (VU) CT images obtained by dual-energy CT can assist clinical diagnosis and reduce radiation dose by obviating true unenhanced imaging (UECT). However, accurate segmentation of all vessels in the head-neck CTA (HNCTA) remains a challenge, and VU images are currently not available from conventional single-energy CT imaging. METHODS In this paper, we proposed a self-supervised dual-task deep learning strategy to fully automatically segment all vessels and predict unenhanced CT images from single-energy HNCTA based on a developed iterative residual-sharing scheme. The underlying idea was to use the correlation between the two tasks to improve task performance while avoiding manual annotation for model training. RESULTS The feasibility of the strategy was verified using the data of 24 patients. For vessel segmentation task, the proposed model achieves a significantly higher average Dice coefficient (84.83%, P-values 10-3 in paired t-test) than the state-of-the-art segmentation model, vanilla VNet (78.94%), and several popular 3D vessel segmentation models, including Hessian-matrix based filter (62.59%), optically-oriented flux (66.33%), spherical flux model (66.91%), and deep vessel net (66.47%). For the unenhanced prediction task, the average ROI-based error compared to the UECT in the artery tissue is 6.1±4.5 HU, similar to previously reported 6.4±5.1 HU for VU reconstruction. CONCLUSIONS Results show that the proposed dual-task framework can effectively improve the accuracy of vessel segmentation in HNCTA, and it is feasible to predict the unenhanced image from single-energy CTA, providing a potential new approach for radiation dose saving. Moreover, to our best knowledge, this is the first reported annotation-free deep learning-based full-image vessel segmentation for HNCTA.
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Affiliation(s)
- Wenjian Huang
- Academy for Advanced Interdisciplinary Studies, Peking University, No.5 Yiheyuan Rd., Beijing, 100871, China.
| | - Weizheng Gao
- Academy for Advanced Interdisciplinary Studies, Peking University, No.5 Yiheyuan Rd., Beijing, 100871, China
| | - Chao Hou
- Department of Radiology, Peking University First Hospital, No.8 Xishiku Street, Beijing, 100034, China
| | - Xiaodong Zhang
- Department of Radiology, Peking University First Hospital, No.8 Xishiku Street, Beijing, 100034, China
| | - Xiaoying Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, No.5 Yiheyuan Rd., Beijing, 100871, China; Department of Radiology, Peking University First Hospital, No.8 Xishiku Street, Beijing, 100034, China.
| | - Jue Zhang
- Academy for Advanced Interdisciplinary Studies, Peking University, No.5 Yiheyuan Rd., Beijing, 100871, China; College of Engineering, Peking University, No.5 Yiheyuan Rd., Beijing, 100871, China.
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Ren B, Tan L, Song Y, Li D, Xue B, Lai X, Gao Y. Cerebral Small Vessel Disease: Neuroimaging Features, Biochemical Markers, Influencing Factors, Pathological Mechanism and Treatment. Front Neurol 2022; 13:843953. [PMID: 35775047 PMCID: PMC9237477 DOI: 10.3389/fneur.2022.843953] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/12/2022] [Indexed: 01/15/2023] Open
Abstract
Cerebral small vessel disease (CSVD) is the most common chronic vascular disease involving the whole brain. Great progress has been made in clinical imaging, pathological mechanism, and treatment of CSVD, but many problems remain. Clarifying the current research dilemmas and future development direction of CSVD can provide new ideas for both basic and clinical research. In this review, the risk factors, biological markers, pathological mechanisms, and the treatment of CSVD will be systematically illustrated to provide the current research status of CSVD. The future development direction of CSVD will be elucidated by summarizing the research difficulties.
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Affiliation(s)
- Beida Ren
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditonal Chinese Medicine, Beijing, China
| | - Ling Tan
- Department of Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuebo Song
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Danxi Li
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditonal Chinese Medicine, Beijing, China
| | - Bingjie Xue
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
- Chinese Medicine Key Research Room of Brain Disorders Syndrome and Treatment of the National Administration of Traditonal Chinese Medicine, Beijing, China
| | - Xinxing Lai
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
| | - Ying Gao
- Department of Neurology, Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing, China
- Institute for Brain Disorders, Beijing University of Chinese Medicine, Beijing, China
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Raman A, Uprety M, Calero MJ, Villanueva MRB, Joshaghani N, Villa N, Badla O, Goit R, Saddik SE, Dawood SN, Rabih AM, Mohammed A, Selvamani TY, Mostafa J. A Systematic Review Comparing Digital Subtraction Angiogram With Magnetic Resonance Angiogram Studies in Demonstrating the Angioarchitecture of Cerebral Arteriovenous Malformations. Cureus 2022; 14:e25803. [PMID: 35706438 PMCID: PMC9187205 DOI: 10.7759/cureus.25803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2022] [Indexed: 11/05/2022] Open
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Maroufi SF, Rafiee Alavi SN, Abbasi MH, Famouri A, Mahya naderkhani, Armaghan S, Allahdadian S, Shahidi A, Nazarian H, Esmaeili S, Bahadori M, Motamed MR, Joghataei MT. Comparison of Doppler Ultrasound and Digital Subtraction Angiography in extracranial stenosis. Ann Med Surg (Lond) 2022; 74:103202. [PMID: 35070286 PMCID: PMC8761599 DOI: 10.1016/j.amsu.2021.103202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/12/2021] [Accepted: 12/19/2021] [Indexed: 10/24/2022] Open
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Jung YM, Kim HJ, Choi WS, Park JY, Seong NJ, Oh KJ, Hong JS, Yoon CJ. CT angiography for the management of postpartum hemorrhage refractory to conservative treatment. J Matern Fetal Neonatal Med 2020; 35:4081-4088. [PMID: 33207995 DOI: 10.1080/14767058.2020.1846708] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Postpartum hemorrhage (PPH) is one of the leading causes of maternal morbidity and mortality. Computerized tomographic (CT) angiography is a useful tool to identify hemorrhage from various conditions. However, the feasibility of CT angiography for the management of PPH has not been well evaluated. OBJECTIVE To evaluate the clinical usefulness of CT angiography in the management of PPH refractory to the conservative treatment. METHODS This retrospective cohort study consisted of 528 consecutive patients who were transferred to our institute after delivery at 28 primary maternity hospitals for the management of PPH between 2009 and 2017. Immediate intervention such as arterial embolization and hysterectomy were performed on 278 patients. Of the remaining 250 patients, CT angiography was performed on 61 patients with hemodynamic stability but with sustained hemorrhage refractory to medical treatment. The diagnostic index was assessed using conventional angiography as the reference standard. The clinical outcome was compared between patients with and without contrast extravasation on CT angiography. RESULTS (1) The prevalence of contrast extravasation was found in 61% of patients (37/61); (2) conventional angiography and arterial embolization were performed in 78% of patients (29/37) with contrast extravasation on CT angiography. Contrast extravasation was confirmed in 83% of patients (24/29) by conventional angiography; (3) among the 24 patients without contrast extravasation on CT angiography, 96% (23/24) were managed conservatively; (4) the patients with contrast extravasation on CT angiography received more packed red blood cell (PRBC) transfusion than those without that condition (7.3 ± 5.2 units vs. 3.8 ± 2.9 units, p = .009). Massive transfusion (defined as transfusion of 10 or more units of PRBC) was more common in patients with contrast extravasation than in those without (27% [10/37] vs. 0% [0/24], p = .004). CONCLUSIONS Conservative treatment succeeded in 96% of patients without contrast extravasation on CT angiography. CT angiography is useful to identify patients requiring intervention in the management of hemorrhage refractory to medical treatment.
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Affiliation(s)
- Young Mi Jung
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University Hospital, Seoul, Korea
| | - Hyeon Ji Kim
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Won Seok Choi
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jee Yoon Park
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Nak Jong Seong
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
| | - Kyung Joon Oh
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Joon-Seok Hong
- Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University, Seoul, Korea.,Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Chang Jin Yoon
- Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Radiology, Seoul National University College of Medicine, Seoul, Korea
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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. Neuroradiology 2020; 63:879-887. [PMID: 33063222 DOI: 10.1007/s00234-020-02581-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 10/06/2020] [Indexed: 10/23/2022]
Abstract
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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