1
|
Su X, Gao Z, Ma Y, Song Z, Zhang H, Zhang P, Ye M. Transarterial embolization for anterior cranial fossa dural arteriovenous fistulas: a retrospective single-center study. J Neurointerv Surg 2024; 16:684-690. [PMID: 37438103 DOI: 10.1136/jnis-2023-020408] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023]
Abstract
BACKGROUND Clip ligation of anterior cranial fossa (ACF) dural arteriovenous fistulas (DAVFs) is the traditionally accepted first-line treatment. Endovascular treatment for ACF DAVFs may achieve good outcomes as endovascular techniques advance. Here we report the clinical and angiographic outcomes in patients with ACF DAVFs who underwent transarterial embolization (TAE) as first-line treatment. METHODS Over a 20-year period, 87.0% (40/46) of patients received TAE as first-line treatment. The clinical presentation, angiographic features, treatment strategy, and clinical and angiographic outcomes are described in this article. RESULTS Forty patients underwent TAE as first-line treatment. There were 36 men and 4 women, with a mean age of 55.6 (55.6±7.4) years. A total of 64 embolization attempts were performed. The middle meningeal artery (66.7%, 12/18) and the ophthalmic artery (54.2%, 13/24) were the most frequently used arterial access routes for complete embolization. The second option was the sphenopalatine artery (46.7%, 7/15). Complications, that is, retinal ischemia, occurred in one patient (2.5%). The total immediate complete occlusion rate for TAE was 82.5% (33/40). Two patients needed surgery for incomplete embolization. When followed up (90%, 36/40), one patient (2.8%, 1/36) reported worsening symptoms due to retinal ischemia following TAE. Although fewer than 50% of the patients received digital subtraction angiography follow-up, there were no recurrences. CONCLUSIONS We show that TAE is safe and effective in the treatment of ACF DAVFs in this study of 40 patients, making it a viable alternative to surgical ligation and transvenous embolization. More research is needed to compare these various treatment modalities.
Collapse
Affiliation(s)
- Xin Su
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China
| | - Zhenzhong Gao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China
- Department of Neurosurgery, The First Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China
| | - Yongjie Ma
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China
| | - Zihao Song
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China
| | - Hongqi Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China
| | - Peng Zhang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China
| | - Ming Ye
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, Beijing, China
| |
Collapse
|
2
|
Kim BK, You SH, Kim B, Shin JH. Deep Learning-Based High-Resolution Magnetic Resonance Angiography (MRA) Generation Model for 4D Time-Resolved Angiography with Interleaved Stochastic Trajectories (TWIST) MRA in Fast Stroke Imaging. Diagnostics (Basel) 2024; 14:1199. [PMID: 38893725 PMCID: PMC11171826 DOI: 10.3390/diagnostics14111199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 06/03/2024] [Accepted: 06/05/2024] [Indexed: 06/21/2024] Open
Abstract
PURPOSE The purpose of this study is to improve the qualitative and quantitative image quality of the time-resolved angiography with interleaved stochastic trajectories technique (4D-TWIST-MRA) using deep neural network (DNN)-based MR image reconstruction software. MATERIALS AND METHODS A total of 520 consecutive patients underwent 4D-TWIST-MRA for ischemic stroke or intracranial vessel stenosis evaluation. Four-dimensional DNN-reconstructed MRA (4D-DNR) was generated using commercially available software (SwiftMR v.3.0.0.0, AIRS Medical, Seoul, Republic of Korea). Among those evaluated, 397 (76.3%) patients received concurrent time-of-flight MRA (TOF-MRA) to compare the signal-to-noise ratio (SNR), image quality, noise, sharpness, vascular conspicuity, and degree of venous contamination with a 5-point Likert scale. Two radiologists independently evaluated the detection rate of intracranial aneurysm in TOF-MRA, 4D-TWIST-MRA, and 4D-DNR in separate sessions. The other 123 (23.7%) patients received 4D-TWIST-MRA due to a suspicion of acute ischemic stroke. The confidence level and decision time for large vessel occlusion were evaluated in these patients. RESULTS In qualitative analysis, 4D-DNR demonstrated better overall image quality, sharpness, vascular conspicuity, and noise reduction compared to 4D-TWIST-MRA. Moreover, 4D-DNR exhibited a higher SNR than 4D-TWIST-MRA. The venous contamination and aneurysm detection rates were not significantly different between the two MRA images. When compared to TOF-MRA, 4D-CE-MRA underestimated the aneurysm size (2.66 ± 0.51 vs. 1.75 ± 0.62, p = 0.029); however, 4D-DNR showed no significant difference in size compared to TOF-MRA (2.66 ± 0.51 vs. 2.10 ± 0.41, p = 0.327). In the diagnosis of large vessel occlusion, 4D-DNR showed a better confidence level and shorter decision time than 4D-TWIST-MRA. CONCLUSION DNN reconstruction may improve the qualitative and quantitative image quality of 4D-TWIST-MRA, and also enhance diagnostic performance for intracranial aneurysm and large vessel occlusion.
Collapse
Affiliation(s)
| | - Sung-Hye You
- Department of Radiology, Anam Hospital, Korea University College of Medicine, #126-1, 5-Ka Anam-dong, Sungbuk ku, Seoul 136-705, Republic of Korea; (B.K.K.); (B.K.); (J.H.S.)
| | | | | |
Collapse
|
3
|
Prasad Balasubramanian A, Kumar Kannath S, Thomas B, Enakshy Rajan J, Kesavadas C. Comparative study of non-contrast silent and time-of-flight magnetic resonance angiographic sequences in the evaluation of intracranial dural arteriovenous fistula. Clin Radiol 2024; 79:e393-e400. [PMID: 38182477 DOI: 10.1016/j.crad.2023.11.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 06/02/2023] [Accepted: 11/21/2023] [Indexed: 01/07/2024]
Abstract
AIM To compare the performance of two non-contrast magnetic resonance angiography (MRA) sequences, silent MRA and time of flight (TOF) MRA, in the evaluation of intracranial dural arteriovenous fistula (DAVF). MATERIALS AND METHODS Forty consecutive patients with DAVF were enrolled and evaluated prospectively using silent MRA, TOF MRA, and digital subtraction angiography (DSA). The location, Cognard classification, arterial feeders, and venous drainage were evaluated. The therapeutic strategy and possible route were predicted on both silent and TOF MRA and these were compared with DSA during subsequent endovascular treatment. RESULTS Sensitivity and accuracy of silent and TOF MRA for localisation (96.4% versus 96% and 96% versus 95%, respectively) and classification (96% versus 94% and 96% versus 93.5%, respectively) were high. Silent MRA showed higher sensitivity than TOF MRA for arterial feeders and draining veins (87% versus 79% and 81.6% versus 67%). This improved to a sensitivity of 96.4% and 89% when prominent feeders were considered. The sensitivity and accuracy were 92.6% and 85.8% for immediate draining veins. Both silent and TOF MRA were accurate for therapeutic planning (96% versus 85%), although silent MRA was more accurate. CONCLUSION Silent MRA can more reliably evaluate the various angioarchtectural components of DAVF compared to TOF MRA.
Collapse
Affiliation(s)
- A Prasad Balasubramanian
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - S Kumar Kannath
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India.
| | - B Thomas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - J Enakshy Rajan
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| | - C Kesavadas
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, India
| |
Collapse
|
4
|
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.
Collapse
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
| |
Collapse
|
5
|
Pinter NK. The Right Imaging Protocol for the Right Patient. Continuum (Minneap Minn) 2023; 29:16-26. [PMID: 36795871 DOI: 10.1212/con.0000000000001209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
OBJECTIVE This article provides a high-level overview of the challenge of choosing the right imaging approach for an individual patient. It also presents a generalizable approach that can be applied to practice regardless of specific imaging technologies. ESSENTIAL POINTS This article constitutes an introduction to the in-depth, topic-focused analyses in the rest of this issue. It examines the broad principles that guide placing a patient on the right diagnostic trajectory, illustrated with real-life examples of current protocol recommendations and cases of advanced imaging techniques, as well as some thought experiments. Thinking about diagnostic imaging strictly in terms of imaging protocols is often inefficient because these protocols can be vague and have numerous variations. Broadly defined protocols may be sufficient, but their successful use often depends largely on the particular circumstances, with special emphasis on the relationship between neurologists and radiologists.
Collapse
|
6
|
Chen X, Ge L, Wan H, Huang L, Jiang Y, Lu G, Wang J, Zhang X. Multimodal MRI diagnosis and transvenous embolization of a basicranial emissary vein dural arteriovenous fistula: A case report. J Interv Med 2023; 6:41-45. [PMID: 37180366 PMCID: PMC10167501 DOI: 10.1016/j.jimed.2022.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 06/03/2022] [Accepted: 07/24/2022] [Indexed: 11/17/2022] Open
Abstract
A dural arteriovenous fistula (DAVF) is an abnormal linkage connecting the arterial and venous systems within the intracranial dura mater. A basicranial emissary vein DAVF drains into the cavernous sinus and the ophthalmic vein, similar to a cavernous sinus DAVF. Precise preoperative identification of the DAVF location is a prerequisite for appropriate treatment. Treatment options include microsurgical disconnection, endovascular transarterial embolization (TAE), transvenous embolization (TVE), or a combination thereof. TVE is an increasingly popular approach for the treatment of DAVFs and the preferred approach for skull base locations, due to the risk of cranial neuropathy caused by dangerous anastomosis from arterial approaches. Multimodal magnetic resonance imaging (MRI) can provide anatomical and hemodynamic information for TVE. The therapeutic target must be precisely embolized in the emissary vein, which requires guidance via multimodal MRI. Here, we report a rare case of successful TVE for a basicranial emissary vein DAVF, utilizing multimodal MRI assistance. The fistula had vanished, pterygoid plexus drainage had improved, and the inferior petrosal sinus had recanalized, as observed on 8-month follow-up angiography. Symptoms and signs of double vision, caused by abduction deficiency, disappeared. Detailed anatomic and hemodynamic assessment by multimodal MRI is the key to guiding successful diagnosis and treatment.
Collapse
Affiliation(s)
| | | | - Hailin Wan
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Lei Huang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yeqing Jiang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Gang Lu
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Jing Wang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaolong Zhang
- Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China
| |
Collapse
|
7
|
Niu J, Ran Y, Chen R, Zhang F, Lei X, Wang X, Li T, Zhu J, Zhang Y, Cheng J, Zhang Y, Zhu C. Use of PETRA-MRA to assess intracranial arterial stenosis: Comparison with TOF-MRA, CTA, and DSA. Front Neurol 2023; 13:1068132. [PMID: 36726752 PMCID: PMC9884682 DOI: 10.3389/fneur.2022.1068132] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 12/22/2022] [Indexed: 01/18/2023] Open
Abstract
Background and purpose Non-invasive and accurate assessment of intracranial arterial stenosis (ICAS) is important for the evaluation of intracranial atherosclerotic disease. This study aimed to evaluate the performance of 3D pointwise encoding time reduction magnetic resonance angiography (PETRA-MRA) and compare its performance with that of 3D time-of-flight (TOF) MRA and computed tomography angiography (CTA), using digital subtraction angiography (DSA) as the reference standard in measuring the degree of stenosis and lesion length. Materials and methods This single-center, prospective study included a total of 52 patients (mean age 57 ± 11 years, 27 men, 25 women) with 90 intracranial arterial stenoses who underwent PETRA-MRA, TOF-MRA, CTA, and DSA within 1 month. The degree of stenosis and lesion length were measured independently by two radiologists on these four datasets. The degree of stenosis was classified according to DSA measurement. Severe stenosis was defined as a single lesion with >70% diameter stenosis. The smaller artery stenosis referred to the stenosis, which occurred at the anterior cerebral artery, middle cerebral artery, and posterior cerebral artery, except for the first segment of them. The continuous variables were compared using paired t-test or Wilcoxon signed rank test. The intraclass correlation coefficients (ICCs) were used to assess the agreement between MRAs/CTA and DSA as well as inter-reader variabilities. The ICC value >0.80 indicated excellent agreement. The agreement of data was assessed further by Bland-Altman analysis and Spearman's correlation coefficients. When the difference between MRAs/CTA and DSA was statistically significant in the degree of stenosis, the measurement of MRAs/CTA was larger than that of DSA, which referred to the overestimation of MRAs/CTA for the degree of stenosis. Results The four imaging methods exhibited excellent inter-reader agreement [intraclass correlation coefficients (ICCs) > 0.80]. PETRA-MRA was more consistent with DSA than with TOF-MRA and CTA in measuring the degree of stenosis (ICC = 0.94 vs. 0.79 and 0.89) and lesion length (ICC = 0.99 vs. 0.97 and 0.73). PETRA-MRA obtained the highest specificity and positive predictive value (PPV) than TOF-MRA and CTA for detecting stenosis of >50% and stenosis of >75%. TOF-MRA and CTA overestimated considerably the degree of stenosis compared with DSA (63.0% ± 15.8% and 61.0% ± 18.6% vs. 54.0% ± 18.6%, P < 0.01, respectively), whereas PETRA-MRA did not overestimate (P = 0.13). The degree of stenosis acquired on PETRA-MRA was also more consistent with that on DSA than with that on TOF-MRA and CTA in severe stenosis (ICC = 0.78 vs. 0.30 and 0.57) and smaller artery stenosis (ICC = 0.95 vs. 0.70 and 0.80). In anterior artery circulation stenosis, PETRA-MRA also achieved a little bigger ICC than TOF-MRA and CTA in measuring the degree of stenosis (0.93 vs. 0.78 and 0.88). In posterior artery circulation stenosis, PETRA-MRA had a bigger ICC than TOF-MRA (0.94 vs. 0.71) and a comparable ICC to CTA (0.94 vs. 0.91) in measuring the degree of stenosis. Conclusion PETRA-MRA is more accurate than TOF-MRA and CTA for the evaluation of intracranial stenosis and lesion length when using DSA as a reference standard. PETRA-MRA is a promising non-invasive tool for ICAS assessment.
Collapse
Affiliation(s)
- Junxia Niu
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuncai Ran
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Rui Chen
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Feifei Zhang
- Department of Magnetic Resonance, Pingmei Shenma Medical Group General Hospital, Pingdingshan, China
| | - Xiaowen Lei
- Department of Magnetic Resonance, Xuchang Central Hospital, Xuchang, China
| | - Xiao Wang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Tengfei Li
- Department of Intervention, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jinxia Zhu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Yong Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Jingliang Cheng
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yan Zhang
- Department of Magnetic Resonance, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China,*Correspondence: Yan Zhang ✉
| | - Chengcheng Zhu
- Department of Radiology, University of Washington, Seattle, WA, United States
| |
Collapse
|
8
|
Tinois J, Danassegarane G, Bretonnier M, Ferré JC, Morandi X, Corniola MV. Multidisciplinary management of posterior fossa dural arteriovenous fistula: A single-center experience. Neurochirurgie 2023; 69:101389. [PMID: 36535082 DOI: 10.1016/j.neuchi.2022.101389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/04/2022] [Accepted: 09/21/2022] [Indexed: 12/23/2022]
Abstract
PURPOSE The management of posterior fossa dural arteriovenous fistulas (pfDAVFs) is challenging. Here, we show how multidisciplinarity leads to their successful management, even in complex cases. METHODS All pfDAVFs managed from 2010 to 2019 at our center were reviewed. The preoperative clinical and radiological characteristics, their management and the occlusion rate were retrieved. The radiological and functional outcomes were retrieved at discharge and last follow-up (FU). RESULTS n=27 patients were included (6 females, mean age: 61-years-old, mean FU: 22.5 months). n=8 patients presented with cerebral hemorrhage. Among patients with ruptured pfDAVFs, n=7 had headache, n=4 had ataxia, and n=2 had impaired level of consciousness. In the unruptured group N (n=19), n=7 patients had headache, n=6 patients had focal neurological deficit, n=4 patients had tinnitus, n=3 (had ataxia, and one presented with seizure. n=24 patients were treated by endovascular therapy (EVT), n=2 patients were treated by microsurgery (MS) and n=1 patient was managed with a combined approach. Re-treatment was necessary in n=6 patients. n=24 patients showed total exclusion at last FU. n=2 patients died during the first 30 days; n=1 patient died during FU. CONCLUSIONS While EVT should be advocated as the first line therapy whenever possible, MS should not be banned from the treatment armamentarium. Neurosurgeons must be able to achieve direct surgical occlusion when the angioarchitecture speaks against EVT.
Collapse
Affiliation(s)
- J Tinois
- Pôle des neurosciences, service de neurochirurgie, centre hospitalier universitaire de Rennes, Rennes, France; Faculté de médecine, université de Rennes 1, Rennes, France; Inserm UMR 1099 LTSI, laboratoire du traitement de signal, unité médicis, université de Rennes 1, Rennes, France
| | - G Danassegarane
- Pôle des neurosciences, service de neurochirurgie, centre hospitalier universitaire de Rennes, Rennes, France
| | - M Bretonnier
- Pôle des neurosciences, service de neurochirurgie, centre hospitalier universitaire de Rennes, Rennes, France; Faculté de médecine, université de Rennes 1, Rennes, France
| | - J-C Ferré
- Faculté de médecine, université de Rennes 1, Rennes, France; Service de radiologie et d'imagerie médicale, centre hospitalier universitaire de Rennes, Rennes, France
| | - X Morandi
- Pôle des neurosciences, service de neurochirurgie, centre hospitalier universitaire de Rennes, Rennes, France; Faculté de médecine, université de Rennes 1, Rennes, France; Inserm UMR 1099 LTSI, laboratoire du traitement de signal, unité médicis, université de Rennes 1, Rennes, France
| | - M V Corniola
- Pôle des neurosciences, service de neurochirurgie, centre hospitalier universitaire de Rennes, Rennes, France; Faculté de médecine, université de Rennes 1, Rennes, France; Faculté de médecine, université de Genève, Geneva, Switzerland; Inserm UMR 1099 LTSI, laboratoire du traitement de signal, unité médicis, université de Rennes 1, Rennes, France.
| |
Collapse
|
9
|
Overview of multimodal MRI of intracranial Dural arteriovenous fistulas. J Interv Med 2022; 5:173-179. [DOI: 10.1016/j.jimed.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 04/05/2022] [Accepted: 04/16/2022] [Indexed: 11/29/2022] Open
|
10
|
Sakata A, Sakamoto R, Fushimi Y, Nakajima S, Hinoda T, Oshima S, Wetzl J, Schmidt M, Okawa M, Yoshida K, Miyamoto S, Nakamoto Y. Low-dose contrast-enhanced time-resolved angiography with stochastic trajectories with iterative reconstruction (IT-TWIST-MRA) in brain arteriovenous shunt. Eur Radiol 2022; 32:5392-5401. [PMID: 35298680 DOI: 10.1007/s00330-022-08678-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 02/06/2022] [Accepted: 02/17/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the feasibility of low-dose contrast-enhanced four-dimensional (4D) time-resolved angiography with stochastic trajectories (TWIST) with iterative reconstruction (hereafter IT-TWIST-MRA) covering the whole brain and to compare IT-TWIST-MRA and TWIST-MRA with reference to digital subtraction angiography (DSA) in the evaluation of arteriovenous shunts (AVS). METHODS Institutional Review Board approval was obtained for this observational study, and the requirement for written informed consent was waived. Twenty-nine patients with known AVS underwent TWIST-MRA on a 3-T MRI scanner, using low-dose injection (0.02 mmol/kg) of gadolinium-based contrast agent (GBCA) with each of Fourier and iterative reconstruction between September 2016 and October 2019. Visual evaluation of image quality was conducted for delineation of (a) the normal cerebral arteries and veins and (b) AVS feeder, shunt, and drainer vessels. Region-of-interest evaluation was conducted to evaluate bolus sharpness and baseline signal fluctuation in the signal intensity of the cerebral vessels. We compared the detection of AVS between TWIST-MRA and IT-TWIST-MRA. The paired-samples Wilcoxon test was used to test the differences between TWIST-MRA and IT-TWIST-MRA. RESULTS Visualization scores for normal vasculature and AVS angioarchitecture were significantly better for images produced using IT-TWIST-MRA than those using TWIST-MRA. Peak signal and the enhancement slope of the time-intensity curve were significantly higher for IT-TWIST-MRA than for TWIST-MRA, except for the superior sagittal sinus (SSS). Baseline intensity fluctuation was significantly lower for IT-TWIST-MRA than for TWIST, except for SSS. CONCLUSIONS IT-TWIST-MRA yields clinically feasible 4D MR-DSA images and delineates AVS even with low-dose GBCA. KEY POINTS • Iterative reconstruction significantly improves the image quality of TWIST-MRA covering the whole brain. • The short temporal footprint and denoising effect of iterative reconstruction enhances the quality of 4D-MRA. • IT-TWIST-MRA yields clinically feasible images of AVS with low-dose GBCA.
Collapse
Affiliation(s)
- Akihiko Sakata
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasutaka Fushimi
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Satoshi Nakajima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takuya Hinoda
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Sonoko Oshima
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Jens Wetzl
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Michaela Schmidt
- Siemens Healthcare GmbH, Allee am Roethelheimpark 2, 91052, Erlangen, Germany
| | - Masakazu Okawa
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yuji Nakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, 54 Shogoin Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| |
Collapse
|