Evaluation of cerebral arteriovenous shunts: a comparison of parallel imaging time-of-flight magnetic resonance angiography (TOF-MRA) and compressed sensing TOF-MRA to digital subtraction angiography

Abstract

Purpose Time-of-flight (TOF)-MR angiography (MRA) is an important imaging sequence for the surveillance and analysis of cerebral arteriovenous shunt (AVS), including arteriovenous malformation (AVM) and arteriovenous fistula (AVF). However, this technique has the disadvantage of a relatively long scan time. The aim of this study was to compare diagnostic accuracy between compressed sensing (CS)-TOF and conventional parallel imaging (PI)-TOF-MRA for detecting and characterizing AVS. Methods This study was approved by the institutional review board for human studies. Participants comprised 56 patients who underwent both CS-TOF-MRA and PI-TOF-MRA on a 3-T MR unit with or without cerebral AVS between June 2016 and September 2018. Imaging parameters for both sequences were almost identical, except the acceleration factor of 3× for PI-TOF-MRA and 6.5× for CS-TOF-MRA, and the scan time of 5 min 19 s for PI-TOF-MRA and 2 min 26 s for CS-TOF-MRA. Two neuroradiologists assessed the accuracy of AVS detection on each sequence and analyzed AVS angioarchitecture. Concordance between CS-TOF, PI-TOF, and digital subtraction angiography was calculated using unweighted and weighted kappa statistics. Results Both CS-TOF-MRA and PI-TOF-MRA yielded excellent sensitivity and specificity for detecting intracranial AVS (reviewer 1, 97.3%, 94.7%; reviewer 2, 100%, 100%, respectively). Interrater agreement on the angioarchitectural features of intracranial AVS on CS-MRA and PI-MRA was moderate to good. Conclusion The diagnostic performance of CS-TOF-MRA is comparable to that of PI-TOF-MRA in detecting and classifying AVS with a reduced scan time under 2.5 min.

Follow-Up Assessment of Intracranial Aneurysms Treated with Endovascular Coiling: Comparison of Compressed Sensing and Parallel Imaging Time-of-Flight Magnetic Resonance Angiography

“…Our findings are in agreement with previous studies which showed comparable results between CS TOF and PI TOF MRA in the detection of a variety of cerebrovascular pathologies, including aneurysms, stenosis and arteriovenous shunts [21][22][23][24][25]. In particular, no significant differences were found between CS TOF and PI TOF MRA in the depiction of intact aneurysms, as well as in the measurement of neck, height and width of aneurysms [22].…”

“…Recent studies showed that CS TOF MRA has comparable sensitivity and specificity to PI TOF MRA in the detection of a variety of cerebrovascular pathologies, including aneurysms, stenosis and arteriovenous shunts, while allowing a 2-to 3-fold reduction in scan time [21][22][23][24][25]. However, no data are available on the diagnostic accuracy of CS TOF MRA in the follow-up of endovascularly treated aneurysms.…”

Vessel wall MR imaging in neuroradiology

“…The risk of hemorrhage is associated with deep venous drainage, and deep and infratentorial brain location [ 79 ], and demographically children and females [ 80 ]. TOF-MRA with wide coverage like a whole brain MRA is necessary to evaluate feeders and nidus of AVM [ 81 ]. CE-MRA or MR-DSA is also performed for evaluation of brain MRA [ 82 ].…”

MRI and MR angiography evaluation of pulsatile tinnitus: A focused, physiology‐based protocol

“…However, recent technical advances have addressed this trade‐off. One example is compressed sensing TOF‐MRA, which capitalizes on the mathematical “sparsity” of information (vessels vs. background), thus enabling accurate diagnosis of arteriovenous (AV) shunting with a sequence time of 2.5 minutes 19 …”