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Neuroimaging
Original research
Non-enhanced MR imaging for preinterventional assessment of the angioarchitecture in vein of Galen malformations
  1. Nikola Reinhard Dürr1,
  2. Waleed Brinjikji2,
  3. Anne Pohrt3,
  4. Henrich Lanfermann4,
  5. Friedhelm Brassel1,
  6. Dan Meila4,5
  1. 1 Department of Radiology and Neuroradiology, Sana Kliniken Duisburg, Zu den Rehwiesen, Duisburg, Germany
  2. 2 Department of Radiology and Neurosurgery, Mayo Clinic, Rochester, Minnesota, USA
  3. 3 Federal Institute for Occupational Safety and Health, Berlin, Germany
  4. 4 Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover, Germany
  5. 5 Department of Interventional Neuroradiology, Johanna-Etienne-Krankenhaus Neuss, Neuss, Germany
  1. Correspondence to Dr Dan Meila, Department of Diagnostic and Interventional Neuroradiology, Medical School Hannover, Hannover D-30625, Germany; dmeila{at}yahoo.de

Abstract

Background and purpose Endovascular treatment of vein of Galen malformations (VGMs) requires sufficient preceding MR imaging. Standardized, preinterventional, non-invasive imaging has not been established. Our study is the first to examine the role of a dedicated, standardized, non-invasive imaging protocol in the evaluation of VGM angioarchitecture by non-contrast MRI/MR angiography.

Materials and methods We retrospectively evaluated a consecutive series of VGM patients who underwent a 1.5 T MRI protocol, including standard T2 weighted images (T2WI), arterial time of flight (TOF), and thin T2WI without flow compensation (T2OffPh). The primary outcome was the proportion of patients in whom VGM subtypes and all arterial feeders (anterior (AChA) and posterior (PChA) choroidal arteries, pericallosal arteries, basilar tip, and leptomeningeal supply) could be accurately identified compared with a DSA gold standard.

Results A total of 26 VGM patients who underwent 108 studies were used in the statistical analysis. VGM subtype was best seen in axial T2OffPh (92.1%) and TOF (89.8%). AChA feeders were best seen in TOF (86.5%) and axial T2OffPh (72.2%). PChA feeders were best seen in TOF (95.1%) and axial T2OffPh (88.1%). Pericallosal feeders were best seen in axial T2OffPh (95.4%) and TOF (95.1%). Basilar tip feeders were best seen in TOF (90.6%) and axial T2OffPh (88.4%).

Conclusion VGM angioarchitecture is best seen in TOF and axial T2OffPh. It can be used as an alternative to global angiographic series.

  • magnetic resonance angiography
  • vascular malformation
  • mri
  • fistula
  • angiography

https://doi.org/10.1136/neurintsurg-2017-013611

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    Footnotes

    • Contributors NRD: acquired, analyzed, and interpreted the data for the work; designed the study; and drafted the manuscript and approved the final manuscript as submitted. WB: acquired, analyzed, and interpreted the data for the work; drafted and revised the manuscript, and approved the final manuscript as submitted. AP: acquired, analyzed, and interpreted the data for the work; and revised the manuscript and approved the final manuscript as submitted. HL: conceptualized the study, and analyzed and interpreted the data for the work; and critically revised the manuscript and approved the final manuscript as submitted. FB: conceptualized the study, and analyzed and interpreted the data for the work; and critically revised the manuscript and approved the final manuscript as submitted. DM: acquired, analyzed, and interpreted the data for the work; designed the study; and drafted the manuscript and approved the final manuscript as submitted. All authors agree to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval The study was approved by our local hospital’s institutional review board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement The authors agree to share data on request.