MR-angiogram-added surface anatomy scanning of superficial cerebral arteriovenous malformations

Our purpose was to evaluate the utility of surface anatomy scanning (SAS) of the brain with superimposition of MR angiograms in the diagnosis and presurgical planning of superficial cerebral arteriovenous malformations (AVMs). We performed SAS in 15 patients with superficial cerebral AVMs. Two-dimensional phase-contrast MR angiograms were then obtained in the same section and superimposed on the SAS images. The images were assessed regarding the visualization of each AVM component using a four-point grading scale (3=excellent to 0=poor). In 13 of the patients, the assessment was made comparing with conventional angiograms. The images were also compared with the surgical findings in 5 patients. The added images agreed well with the angiographic findings and demonstrated the relationships between the AVM components and the adjacent brain surface. The average scores of the feeder(s), nidus, and drainer(s) were 2.27, 2.33, and 2.67, respectively. The surgical findings also correlated well with the added images. Our technique can noninvasively demonstrate superficial AVMs along with the brain surface and provide information useful for planning surgery.