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Related Experiment Videos

Hyperintense thrombus on GRASS MR images: potential pitfall in flow evaluation.

D M Yousem1, J Balakrishnan, G M Debrun

  • 1Neuroradiology Division, Johns Hopkins Hospital, Baltimore, MD 21205.

AJNR. American Journal of Neuroradiology
|January 1, 1990
PubMed
Summary

Gradient-recalled acquisition in the steady state (GRASS) MRI may show intraluminal hyperintensity mimicking persistent blood flow in treated arteriovenous malformations. Short TR/TE spin-echo sequences are crucial for accurate assessment of embolization success.

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Area of Science:

  • Neuroradiology
  • Vascular Imaging
  • Magnetic Resonance Imaging (MRI)

Background:

  • Gradient-recalled acquisition in the steady state (GRASS) is a common MRI sequence used in neurovascular imaging.
  • Assessing the success of embolization for cerebral arteriovenous malformations (AVMs) requires accurate differentiation between residual blood flow and post-treatment changes.

Observation:

  • In four patients with successfully occluded cerebral AVMs, GRASS MRI demonstrated intraluminal hyperintense signal.
  • This hyperintensity was initially misinterpreted as persistent blood flow.
  • Short TR/TE spin-echo sequences revealed hyperintense signal instead of expected flow void, indicating subacute thrombus.

Findings:

  • GRASS MRI findings of intraluminal hyperintensity in treated AVMs can be misleading.

Related Experiment Videos

  • The hyperintensity observed is indicative of subacute thrombus, not residual blood flow.
  • Short TR/TE spin-echo sequences are essential for correct interpretation.

    • Implications:

    • GRASS images alone are insufficient for determining the success of AVM embolization or aneurysm patency.
    • Radiologists must use corroborative imaging, especially short TR/TE spin-echo sequences, to avoid misinterpretation of subacute thrombus as flow.
    • Accurate assessment is critical for patient management and treatment planning in neurovascular interventions.