Arteriovenous malformations of the extremities: MR imaging

Eight patients with angiographically proved arteriovenous malformations (AVMs) of the extremities (seven congenital, one posttraumatic) were evaluated with magnetic resonance (MR) imaging using a 0.35-T superconducting system and spin-echo pulse sequences. Congenital AVMs appeared as accumulations of dilated tortuous blood vessels infiltrating the involved muscles. A posttraumatic acquired AVM of the shoulder consisted of a large feeding artery associated with a pseudoaneurysm and a soft-tissue mass. MR imaging allowed precise anatomic localization and provided details concerning the size and extent of the AVMs. The relationship of AVMs to specific muscle groups, bones, and vascular structures could be accurately determined. Although major feeding and draining vessels were identified, the exact arteries and veins supplying and draining the AVM could not be ascertained. Images obtained in the transverse plane consistently yielded the most useful information. MR imaging and angiography may be complementary techniques in the initial evaluation, follow-up, and treatment planning of AVMs of the extremities.