Predictive Value of MRI in Diagnosing Brain AVM Recurrence after Angiographically Documented Exclusion in Children

Abstract

BACKGROUND AND PURPOSE: MRI is routinely performed following brain AVM after treatment in children. Our aim was to determine the predictive values of contrast-enhanced MR imaging and TOF-MRA for brain AVM recurrence in children, compared with conventional angiography and the role of 3D rotational angiography-MR imaging fusion in these cases. MATERIALS AND METHODS: We included all pediatric patients with brain AVMs during an 18-year period with angiographically documented obliteration after treatment. Patients underwent 3T MR imaging, including contrast-enhanced MR imaging, TOF-MRA, and conventional angiography, with a subset undergoing 3D rotational angiography. The predictive values of contrast-enhanced MR imaging and TOF-MRA for brain AVM recurrence were determined. CTA sections reconstructed from 3D rotational angiography were coregistered with and fused to 3D-T1WI for analysis.

Cerebral Arteriovenous Malformation Recurrence After Complete Surgical Excision in an Adult: Case Report and Review of the Literature

“…Based on suggested follow-up in children [31] and from the adult cases thus far, follow-up for 10 years, with routine imaging at 1 year, 5 years, 10 years and for any new or progressive neurological signs and symptoms, would be reasonable. Although DSA is still the gold standard modality and was utilized to detect recurrence in all reported cases, a 2019 study found that contrast-enhanced magnetic resonance imaging and angiography (MRI/MRA) was suitable for surveillance, with DSA subsequently used for confirmation [32].…”

Ruptured Arteriovenous Malformation Anterior to the Brainstem to a Child with Subsequent Spontaneous Thrombosis: Case Report and Literature Review

“…To the best of our knowledge, the most recently published analysis about the issue of AVM surveillance concludes that MRI as a surveillance imaging modality for that patient population should, at present, be supplemented by conventional angiography. This is based upon the fact that when TOF-MRA and contrast enhanced MRI are collectively used and interpreted together, their complementary predictive value is in the order of 85%, compared with conventional angiography [34].…”

Multimodality treatment for brain arteriovenous malformation in Mainland China: design, rationale, and baseline patient characteristics of a nationwide multicenter prospective registry

“…The secondary outcomes: obliteration rate, subsequent hemorrhage, complication rate, and improvement in clinical symptoms (epilepsy, headache, neurological dysfunction) at 3 years after treatment. The obliteration rate will be evaluated by DSA or MRI, as several previous studies have suggested that MRI could provide a similar assessment of the obliteration rate as DSA [ 18 ]. The subsequent hemorrhage is defined as intracranial hemorrhage that could be attributed to AVM rupture with symptomatic and CT evidence.…”