Measurement of Blood Flow in Arteriovenous Malformations before and after Embolization Using Arterial Spin Labeling

Suazo, Luis; Foerster, Bradley R.; Fermin, R; Speckter, Herwin; Vilchez, C; Oviedo, Jairo; Stoeter, P.

doi:10.1177/159101991201800106

Cited by 19 publications

(18 citation statements)

References 24 publications

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“…In the present study, the main angioarchitectural characteristics of the brain AVMs were generally identical to those described by others (27,32). Although AVM embolization is a commonly approved practice, it also offers a unique opportunity to analyze the poorly understood mechanisms that govern regulation of cerebral venous tone.…”

Section: Discussionsupporting

confidence: 85%

Evidence of active regulation of cerebral venous tone in individuals undergoing embolization of brain arteriovenous malformations

Ivanov

Петров

Vershinina

et al. 2013

Journal of Applied Physiology

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Cerebral venous drainage is generally believed to be regulated primarily by hydrodynamic forces. To gain further insight into the regulation of this process, we investigated the response of blood flow velocity and cross-sectional area (CSA) of the internal jugular veins (IJVs) to local hemodynamic shifts. All procedures and assessments were performed on patients (n = 30) undergoing embolization of brain arteriovenous malformations (AVMs). The procedure efficiency was verified by the postembolization reduction in time-averaged maximum blood flow velocities, as well as the elevation of pulsatility index and resistance index in the arterial feeders. In cerebral veins, the dominant IJV pressure remained unchanged during the procedure. At the same time, AVM embolization caused a significant reduction in maximal CSA (84 ± 7.6 to 68 ± 7.7 mm(2), P < 0.05) and minimal CSA (68 ± 7.0 to 51 ± 7.0 mm(2), P < 0.01) of the IJV located ipsilateral to the AVM, while the maximal linear blood flow velocity in the IJV remained unchanged (71 ± 4.9 and 85 ± 8.4 cm/s, P = 0.098). Consistent with previously published studies, the data obtained provide further evidence of active regulation of the venous outflow, probably mediated by certain neurogenic and/or endothelium-dependent mechanisms.

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Section: Discussionsupporting

confidence: 85%

Evidence of active regulation of cerebral venous tone in individuals undergoing embolization of brain arteriovenous malformations

Ivanov

Петров

Vershinina

et al. 2013

Journal of Applied Physiology

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“… 13 Total blood flow in high-flow lesions may also be underestimated on ASL, as regions of interests may include not only the high-flow nidus but also the arterial feeders and draining veins, resulting in an average value for flow. 10 Finally, there is a theoretical risk of signal inhomogeneities in certain vascular territories, depending on the location of the PVM and its arterial supply with regards to the labelling plane. This is a phenomenon that has been demonstrated in intracranial ASL imaging.…”

Section: Discussionmentioning

confidence: 99%

Novel use of arterial spin labelling in the imaging of peripheral vascular malformations

et al. 2020

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We present a novel use of arterial spin labelling (ASL), a MRI perfusion technique, to assess a high-flow, peripheral vascular malformation (PVM), specifically a large arteriovenous malformation in the left forearm of a 20-year-old female. While there has been experience with ASL in the assessment of intracranial vascular malformations, there has been no known use of ASL in the evaluation of PVMs. We also discuss the potential benefits and limitations of ASL in the imaging of PVMs. The promising results from this case warrant further research on ASL in the investigation of PVMs.

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“…Arteriovenous malformation (AVM) has an associated ‘steal phenomenon’ that has been visualised with PASL [ 62 ]. PASL was also shown to be useful in measuring the amount of shunt reduction achieved after embolisation of AVMs [ 63 ], as well as confirming obliteration of AVM after stereotactic radiosurgery [ 64 , 65 ]. Vessel-encoded pCASL was found to be as good as DSA at identifying AVM feeding vessels and their contribution fractions [ 66 ].…”

Section: Clinical Applicationsmentioning

confidence: 99%

A neuroradiologist’s guide to arterial spin labeling MRI in clinical practice

et al. 2015

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Arterial spin labeling (ASL) is a non-invasive MRI technique to measure cerebral blood flow (CBF). This review provides a practical guide and overview of the clinical applications of ASL of the brain, as well its potential pitfalls. The technical and physiological background is also addressed. At present, main areas of interest are cerebrovascular disease, dementia and neuro-oncology. In cerebrovascular disease, ASL is of particular interest owing to its quantitative nature and its capability to determine cerebral arterial territories. In acute stroke, the source of the collateral blood supply in the penumbra may be visualised. In chronic cerebrovascular disease, the extent and severity of compromised cerebral perfusion can be visualised, which may be used to guide therapeutic or preventative intervention. ASL has potential for the detection and follow-up of arteriovenous malformations. In the workup of dementia patients, ASL is proposed as a diagnostic alternative to PET. It can easily be added to the routinely performed structural MRI examination. In patients with established Alzheimer’s disease and frontotemporal dementia, hypoperfusion patterns are seen that are similar to hypometabolism patterns seen with PET. Studies on ASL in brain tumour imaging indicate a high correlation between areas of increased CBF as measured with ASL and increased cerebral blood volume as measured with dynamic susceptibility contrast-enhanced perfusion imaging. Major advantages of ASL for brain tumour imaging are the fact that CBF measurements are not influenced by breakdown of the blood–brain barrier, as well as its quantitative nature, facilitating multicentre and longitudinal studies.

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Measurement of Blood Flow in Arteriovenous Malformations before and after Embolization Using Arterial Spin Labeling

Cited by 19 publications

References 24 publications

Evidence of active regulation of cerebral venous tone in individuals undergoing embolization of brain arteriovenous malformations

Evidence of active regulation of cerebral venous tone in individuals undergoing embolization of brain arteriovenous malformations

Novel use of arterial spin labelling in the imaging of peripheral vascular malformations

A neuroradiologist’s guide to arterial spin labeling MRI in clinical practice

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