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Non-invasive Cerebral Arteriovenous Malformation Nidus Volume Measurement: Silent MRA Compared with TOF-MRA1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China, 2China International Neuroscience Institute, Beijing, China, 3Department of Radiology and Nuclear Medicine, Xuanwu Hospital, Capital Medical University, Beijing, China, 4Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Beijing, China, 5The National Center for Neurological Disorders, Xuanwu Hospital, Capital Medical University, Beijing, China
Synopsis
Keywords: Blood Vessels, Image Reconstruction, Cerebral arteriovenous malformations . Digital Subtraction Angiography. Magnetic resonance angiography . Nidus segmentation . Nidus volume
Motivation: Quantitative nidus volume measurement of cerebral arteriovenous malformation（CAVM）is of great important for the CAVM treatment management.
Goal(s): This study aims to investigate non-invasive nidus volume measurement of CAVM with silent MRA and explore the difference between silent MRA and TOF-MRA.
Approach: Nidus volume was measured by silent MRA, TOF-MRA, and digital subtraction angiography（DSA）. Nidus volume measured by DSA was regarded as golden standard.
Results: Silent MRA can accurately measure the nidus volume of CAVM. There is a significant difference in nidus volume measurement between silent MRA and TOF-MRA, silent MRA also has advantage for CAVM patients treated by embolization.
Impact: As a non-invasive and contrast agent-free MRA imaging technology, silent MRA can be used as an effective and accurate imaging tool for nidus volume measurement and as a follow-up tool for nidus volume change evaluation after surgery, embolization, and radiotherapy.
INTRODUCTION
Accurate cerebral arteriovenous malformations (CAVM) nidus volume measurement is of essential importance for evaluating treatment strategy and neurological prognosis.This study aimed to compare the accuracy of silent MR angiography (MRA) for measuring CAVM nidus volume with time-of-flight MR angiography (TOF-MRA) and analyze the clinical factors that may affect the nidus volume measurement.METHODS
A total of 80 patients diagnosed with CAVM who received silent MRA, TOF-MRA, and digital subtraction angiography（DSA）examinations were retrospectively reviewed. A standardized nidus volume measurement protocol was used to measure the nidus volume by these three imaging tools.RESULTS
The mean nidus volume measured by 3D-DSA, silent MRA, and TOF-MRA was 9.073±7.667 ml, 9.55±7.814 ml, and 7.773±7.11ml, respectively. The mean nidus volume difference was 0.477±1.715 ml (P =0.069) and 1.30±2.0 0 ml (P=0.00) between 3D-DSA and silent MRA, 3D-DSA, and TOF-MRA, respectively. The linear correlation coefficient of the nidus volume was 0.976 (P<0.001) and 0.966 (P<0.001), respectively. For nidus overlap volume and volume discrepancy, Psilentol (0.775±0.109) was significantly higher than Ptofol (0.538±0.206)(P=0.00), and Ptofdis (0.196±0.192) was significantly higher than Psilentdis (0.114±0.147) (P=0.005). For both silent MRA and TOF MRA, the nidus overlap volume and volume discrepancy were significantly associated with previous embolization status.CONCLUSION
Nidus volume measurement by silent MRA is accurate and practical. Silent MRA can be used for nidus volume measurement and as a follow-up tool for nidus volume change evaluation after surgery, embolization, and radiotherapy.Acknowledgements
We are grateful to Doctor Juan Wei of GE Healthcare for technical support.References
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Figures
The comparison of nidus volume measurement results between 3D-DSA and silent MRA/ TOF-MRA
The comparison of overlapping, over-cover nidus volume and nidus volume differences in different imaging modalities
The influence of clinical factors on nidus volume measurement
Standardized nidus volume measurement protocol proposed by our team. Green: 3D-DSA. Red: silent MRA. Blue: TOF-MRA.
Illustration of a CAVM case measured by 3D-DSA, silent MRA, and TOF-MRA. Green: 3D-DSA. Red: silent MRA. Blue: TOF-MRA. Yellow: overlapping volume. Purple: over-cover volume.