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Differentiating Components of Cerebral Arteriovenous Malformations Using T1-Weighted Gradient Recall Echo MR Imaging
1Chang-Gung Memorial Hospital; Guishan Township, Taoyuan, Taiwan - playtone2u@yahoo.com.
Abstract:
Cerebral arteriovenous malformation (AVM) typically shows signal void on conventional MR images, making differentiation of each component difficult. We analyzed the MR signal intensity of AVM components on T1-weighted gradient recalled echo pulse sequence images. We retrospectively studied 29 patients with AVM between 2006 and 2008. Patients were excluded if they had 1) intracranial hemorrhage, 2) previous intervention for AVM. All patients underwent MR study on a 3T system (Magentom TIM Trio, Siemens). Pulse sequences included T1-weighted gradient recalled echo (T1GRE), T2-weighted (T2), time-of-flight (TOF), and contrast-enhanced T1-weighted (cT1) images. Digital subtracted angiography (DSA) was performed in all patients as a diagnostic standard. Signal intensity of each AVM component was recorded and compared between pulse sequences. Nine patients were studied (five men; mean age 39.1 years) and nine AVM were identified (mean size, 3.9 cm). Three different signal intensities (hypo-, iso-, and hyper-intensity) were observed in all nine patients on T1GRE. Only one signal intensity was seen on T2 (flow void) and cT1 images (hyperintensity) in nine patients. Two different signal intensities were observed in all seven patients with TOF images. The T1GRE image showed the largest number of different signal intensities of AVM when compared with other pulse sequences, thus providing clearer structural delineation. Routine use of the T1GRE pulse sequence can help pre-therapeutic planning or follow-up of AVM.
Insights
T1-weighted gradient recalled echo (T1GRE) MRI sequences reveal varied signal intensities in cerebral arteriovenous malformations (AVMs). This technique offers superior structural delineation for AVMs compared to other MRI sequences, aiding treatment planning.
Area of Science:
- Neuroradiology
- Medical Imaging
- Cerebrovascular Diseases
Background:
- Cerebral arteriovenous malformations (AVMs) present challenges in conventional MRI due to signal void.
- Differentiating AVM components on standard MRI sequences is often difficult.
Purpose of the Study:
- To analyze the MR signal intensity of cerebral arteriovenous malformation components using T1-weighted gradient recalled echo (T1GRE) pulse sequences.
- To compare the efficacy of T1GRE sequences with other MRI sequences for AVM structural delineation.
Main Methods:
- Retrospective study of 29 patients with cerebral AVMs (2006-2008), excluding those with hemorrhage or prior intervention.
- All patients underwent MRI on a 3T system, including T1GRE, T2-weighted, time-of-flight (TOF), and contrast-enhanced T1-weighted (cT1) sequences.
- Digital subtracted angiography (DSA) served as the diagnostic standard; signal intensities of AVM components were recorded and compared across sequences.
Main Results:
- Nine patients (mean age 39.1 years) with nine AVMs (mean size 3.9 cm) were analyzed.
- T1GRE sequences demonstrated three distinct signal intensities (hypo-, iso-, hyper-intensity) in all patients.
- T2 and cT1 images showed only one signal intensity, while TOF images showed two; T1GRE provided the clearest structural delineation.
Conclusions:
- T1-weighted gradient recalled echo (T1GRE) pulse sequences offer superior visualization of cerebral AVM components compared to conventional MRI sequences.
- The ability of T1GRE to display varied signal intensities enhances structural delineation, proving beneficial for pre-therapeutic planning and follow-up of AVMs.
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