Noncontrast-enhanced four-dimensional MR angiography for the evaluation of cerebral arteriovenous malformation: a preliminary trial.

PURPOSE: To prospectively evaluate noncontrast-enhanced (NCE), time resolved, four-dimensional (4D) magnetic resonance angiography (MRA) for assessment of cerebral arteriovenous malformation (AVM), with intraarterial digital subtraction angiography (DSA) performed as the reference standard.

MATERIALS AND METHODS: Fifteen patients (ten men, five women; age range 2-59 years, mean 29.4 years) with 15 untreated cerebral AVMs comprised the study population. NCE 4D MRA was performed on a 3.0 T MR scanner. MR images were reviewed by two independent readers and compared with DSA with respect to arterial feeders, nidus size, and venous drainage. Kappa coefficients of concordance were computed to determine the interobserver and intermodality agreements for the depiction of arterial feeders, nidus, and venous drainage between the two techniques.

RESULTS: Fifteen AVMs detected in DSA were visualized in NCE 4D MRA. Intermodality agreements were excellent for the arterial feeders (K = 0.918, P = 0.000), good for the nidus size (K = 0.692, P = 0.000), and moderate for the venous drainage (K = 0.495, P = 0.001).

CONCLUSION: NCE 4D MRA is a promising and potentially valuable method for noninvasive assessment of angioarchitecture and hemodynamics of cerebral AVMs. Further improvement of labeling persistence is desirable in order to enhance the depiction of draining veins for AVMs.