Usefulness of three-dimensional phase contrast MR angiography on arteriovenous malformations

Prospective three-dimensional phase contrast (3D-PC) MR angiography was obtained in 34 patients with arteriovenous malformations (AVM) and comparison was made between digital substraction angiography (DSA) and three-dimensional time-of-flight (3D-TOF) methods. Velocity encoding (VENC) for 3D-PC was adjusted to 60 and 10 cm/sec., and was changed only when adequate information was not obtained. VENC 60 cm/sec, demonstrated the main feeders in 100% of cases and the nidus in 86% of cases whereas VENC 10 cm/sec. showed the draining vein in 78% of cases. The detection rate of feeder, nidus and drainer was 60%, 40% and 13% respectively by the TOF technique. The mean size of the nidus as compared with DSA as standard was 130% with MRI, 108% with 3D-PC and 92% with the TOF technique and this difference was not statistically significant. 3D-PC was clearly superior in detecting AVM in the presence of hemosiderin, hematoma or surgical clips. It also showed gradual disappearance of the lesion after radiosurgery. We found 3D-PC superior to 3D-TOF in the diagnosis, therapeutic planning and follow-up of AVM.