• Academic radiology · Nov 2012

    Usefulness of 3D DSA-MR fusion imaging in the pretreatment evaluation of brain arteriovenous malformations.

    • Satoru Ide, Toshinori Hirai, Motohiro Morioka, Yutaka Kai, Shigetoshi Yano, Takayuki Kawano, Shuichi Tochihara, Yoshinori Shigematsu, Hiroyuki Uetani, Yu Murakami, Keita Watanabe, and Yasuyuki Yamashita.
    • Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Honjo, Kumamoto, Japan.
    • Acad Radiol. 2012 Nov 1;19(11):1345-52.

    Rationale And ObjectivesFor the evaluation of patients scheduled for the treatment of brain arteriovenous malformations (AVMs), accurate anatomical information is essential. The purpose of this study was to assess the usefulness of three-dimensional (3D) digital subtraction angiography (DSA)-magnetic resonance (MR) fusion imaging for the pretreatment evaluation of AVMs.Materials And MethodsThe study population consisted of 11 consecutive patients (7 males, 4 females; age 10-72 years; mean 45 years) with brain AVMs. All prospectively underwent pretreatment MR imaging (MRI), MR angiography (MRA), and two-dimensional (2D) and 3D DSA. The 3D DSA and MR images were semiautomatically fused with fusion software on a workstation. In the delineation of AVM nidus, feeder, drainer, and relationship between AVM and the adjacent brain structures, two radiologists independently evaluated MRA and MRI, three-dimensional (3D) DSA, and MRI, and 3D DSA-MR fusion images using a 4-point scoring system. The referring neurosurgeons were asked whether the information provided by 3D DSA-MR fusion images was helpful for treatment decisions.ResultsFor all four items, the delineation was significantly better with the 3D DSA/MRI or 3D DSA-MR fusion images than the MRA/MRI images. Although the delineation for the nidus, feeder, and drainer were not significantly different between the 3D DSA/MRI and 3D DSA-MR fusion images, 3D DSA-MR fusion imaging were significantly better for the relationship between AVM and the adjacent brain structures than 3D DSA/MR imaging (P = .0047). The information provided by 3D DSA-MR fusion images was helpful for treatment decisions in all cases.Conclusion3D DSA-MR fusion images are useful for the pretreatment evaluation of brain AVMs.Copyright © 2012 AUR. Published by Elsevier Inc. All rights reserved.

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