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Magnetic resonance angiography in 140 neuropediatric patients
1Department of Pediatrics, Faculty of Clinical Medicine Mannheim, University of Heidelberg, Germany.
Abstract:
Three-dimensional magnetic resonance angiography (MRA) is a noninvasive technique that images the intracranial arterial vasculature without contrast agents. The suitability of MRA was evaluated for routine use and all children were prospectively studied with conventional MR imaging and time off flight MRA (FISP3D). All MR studies were performed on a 1.5 T-MRA system using a circularly polarized head coil. The study comprised 140 children, ages 3 weeks to 18 years, with different neuropediatric diseases. Major cervical and intracranial arteries were visualized in all age groups. Smaller branches of the supratentorial arteries were identified inconstantly and the number of arteries visualized increased up to the age of 6 years. Sixty-seven children (47%) had normal intracranial vasculature. MRA demonstrated anatomic variations in 21 patients (15%). Twenty-two of 32 children with congenital malformations demonstrated abnormalities of the intracranial vasculature. The diagnostic value of MRA was confirmed in 11 of 12 patients after neonatal stroke and in 3 of 10 children after stroke at older ages. Seven of 18 children with acute hemorrhage demonstrated arteriovenous malformations or an aneurysm on MRA. The correlation with digital subtraction angiographic findings was established in 13 patients. In 9 of 13 children with brain tumor, MRA proved to be diagnostically valuable. MRA proved to be of particular value in the evaluation of the carotid artery following extracorporeal membrane oxygenation therapy. MRA can be used in children of all age groups.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Three-dimensional magnetic resonance angiography (MRA) is a noninvasive tool for imaging children's brain arteries. This study shows MRA is suitable for routine use in diagnosing various pediatric neurological conditions.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Noninvasive imaging of pediatric intracranial vasculature is crucial for diagnosing neurological conditions.
- Conventional contrast-enhanced angiography carries risks, necessitating safer alternatives.
Purpose of the Study:
- To evaluate the suitability of three-dimensional magnetic resonance angiography (MRA) for routine use in pediatric patients.
- To assess the diagnostic value of MRA in various neuropediatric diseases.
Main Methods:
- Prospective study of 140 children (3 weeks to 18 years) using conventional MR imaging and time-of-flight MRA (FISP3D) on a 1.5 T system.
- Evaluation of major cervical and intracranial arteries, including smaller supratentorial branches.
- Correlation with digital subtraction angiography in select cases.
Main Results:
- MRA visualized major arteries in all age groups; smaller branches were inconsistently identified, improving with age up to 6 years.
- Normal intracranial vasculature found in 47% of patients; MRA detected anatomic variations in 15%.
- MRA demonstrated abnormalities in congenital malformations, post-stroke cases, hemorrhage, brain tumors, and post-extracorporeal membrane oxygenation therapy.
Conclusions:
- Three-dimensional MRA is a valuable, noninvasive tool for evaluating intracranial arterial vasculature in children across all age groups.
- MRA is suitable for routine use in diagnosing a spectrum of pediatric neurological and vascular conditions.