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- Title
Distinguishing high-flow from low-flow vascular malformations using maximum intensity projection images in dynamic magnetic resonance angiography - comparison to other MR-based techniques.
- Authors
Kociemba, Anna; Karmelita-Katulska, Katarzyna; Stajgis, Marek; Oszkinis, Grzegorz; Pyda, Małgorzata
- Abstract
<bold>Background: </bold>In addition to ultrasound, magnetic resonance imaging (MRI) is considered a suitable, non-invasive technique to assess the type and extent of vascular malformations. The distinction between low- and high-flow lesions is crucial because it determines appropriate patient treatment.<bold>Purpose: </bold>To distinguish high-flow from low-flow lesions on the basis of the enhancement pattern on MIP images acquired from dynamic time-resolved MR angiography (MRA) and compare it with previously described MR-based methods.<bold>Material and Methods: </bold>We examined 25 consecutive patients with previously diagnosed vascular malformations. Next, each malformation was classified as "high-flow" or "low-flow" using the following criteria: (i) findings on T1-weighted (T1W) and T2-weighted (T2W) imaging (signal voids, signal intensity); (ii) the time interval between the start of arterial enhancement and the onset of lesion enhancement (artery-lesion time); (iii) the time of maximum lesion enhancement; and (iv) analysis of the slope of the enhancement curve.<bold>Results: </bold>Of the 25 patients, seven had high-flow and 18 had low-flow malformations. Signal voids on spin-echo T1W images were observed only in four of seven high-flow malformations and in two of 18 low-flow malformations. Analysis of signal intensity on T2W images showed increased signal intensity in 17 of 18 low-flow malformations, and in two of seven high-flow lesions. Calculation of the artery-lesion time, maximum enhancement time, and slope revealed significant differences between the high- and low-flow groups.<bold>Conclusion: </bold>In conclusion, the slope of the enhancement curve appears to be useful in distinguishing between high- and low-flow vascular malformations. Standardization of MR image evaluation criteria is essential.
- Subjects
MAGNETIC resonance imaging; MAGNETIC resonance angiography; SCLEROTHERAPY; ULTRASONIC imaging; DIGITAL angiography; BLOOD flow measurement; BLOOD-vessel abnormalities; COMPARATIVE studies; DIAGNOSTIC imaging; HEMODYNAMICS; RESEARCH methodology; MEDICAL cooperation; RESEARCH; EVALUATION research
- Publication
Acta Radiologica, 2016, Vol 57, Issue 5, p565
- ISSN
0284-1851
- Publication type
journal article
- DOI
10.1177/0284185115615005