Magnetic resonance angiography: a three-dimensional database for assessing arteriovenous malformations

Abstract

✓ Stereotactic angiography has long been the “gold standard” in the diagnosis of patients with arteriovenous malformations (AVM's). Although orthogonal or stereoshift images may suffice in discerning the shape and location of spherical malformations, an exact analysis and assessment of most nonspherical malformations are hampered by the fact that stereotactic angiographic images compress three-dimensional (3-D) data into two-dimensional views. As a consequence, the complex 3-D shape of an AVM can never be fully and truly discerned from conventional angiography. With the recent explosion of radiosurgical techniques, more and more AVM's are being treated noninvasively. These radiosurgical techniques require 3-D visualization to maximize nidus coverage and minimize normal brain irradiation. Alternatives to stereotactic angiography are therefore desperately needed. An entire new family of pulse sequences is now available that permits visualization of the vascular system using magnetic resonance imaging. A brief technical review of magnetic resonance angiography is presented, and its potential role(s) in the assessment and radiosurgical treatment of AVM's is explored.