Diagnostic Accuracy of Non-Contrast-Enhanced Time-Resolved MR Angiography to Assess Angioarchitectural Classification Features of Brain Arteriovenous Malformations

Diagnostic Accuracy of Non-Contrast-Enhanced Time-Resolved MR Angiography to Assess Angioarchitectural Classification Features of Brain Arteriovenous Malformations

This study aims to assess the diagnostic accuracy of non-contrast-enhanced 4D MR angiography (NCE-4D-MRA) compared to contrast-enhanced 4D MR angiography (CE-4D-MRA) for the detection and angioarchitectural characterisation of brain arteriovenous malformations (bAVMs). Utilising a retrospective desi...

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Bibliographic Details
Published in:Diagnostics (Basel) Vol. 14; no. 15; p. 1656
Main Authors: Chauvet, Grégoire, Cheddad El Aouni, Mourad, Magro, Elsa, Sabardu, Ophélie, Ben Salem, Douraied, Gentric, Jean-Christophe, Ognard, Julien
Format: Journal Article
Language:English
Published: Switzerland MDPI AG 01-08-2024
Subjects:
Accuracy
Angiography
Arteriovenous malformations
AVMES
brain arteriovenous malformations
buffalo
Catheters
Comparative analysis
contrast-enhanced MR angiography
Diagnosis
Labeling
Medical imaging
Medical imaging equipment
non-contrast-enhanced MR angiography
Spetzler–Martin
France
Netherlands
brain arteriovenous malformations
non-contrast-enhanced MR angiography
buffalo
Spetzler–Martin
R2DAVM
AVMES
contrast-enhanced MR angiography
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Summary:This study aims to assess the diagnostic accuracy of non-contrast-enhanced 4D MR angiography (NCE-4D-MRA) compared to contrast-enhanced 4D MR angiography (CE-4D-MRA) for the detection and angioarchitectural characterisation of brain arteriovenous malformations (bAVMs). Utilising a retrospective design, we examined 54 MRA pairs from 43 patients with bAVMs, using digital subtraction angiography (DSA) as the reference standard. Both NCE-4D-MRA and CE-4D-MRA were performed using a 3-T MR imaging system. The primary objectives were to evaluate the diagnostic performance of NCE-4D-MRA against CE-4D-MRA and DSA and to assess concordance between imaging modalities in grading bAVMs according to four main scales: Spetzler-Martin, Buffalo, AVM embocure score (AVMES), and R2eDAVM. Our results demonstrated that NCE-4D-MRA had a higher accuracy and specificity compared to CE-4D-MRA (0.85 vs. 0.83 and 95% vs. 85%, respectively) and similar agreement, with DSA detecting shunts in bAVMs or residuals. Concordance in grading bAVMs was substantial between NCE-4D-MRA and DSA, particularly for the Spetzler-Martin and Buffalo scales, with CE-4D-MRA showing slightly higher kappa values for interobserver agreement. The study highlights the potential of NCE-4D-MRA as a diagnostic tool for bAVMs, offering comparable accuracy to CE-4D-MRA while avoiding the risks associated with gadolinium-based contrast agents. The safety profile of imaging techniques is a significant concern in the long-term follow up of bAVMs, and further prospective research should focus on NCE-4D-MRA protocol improvement for clinical use.
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ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics14151656