1. In-room assessment of intravascular velocity from time-resolved rotational angiography in patients with arteriovenous malformation: a pilot study
- Author
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Chung Jung Lin, Hsiu Mei Wu, Chao Bao Luo, Chih Chun Wu, Wan-Yuo Guo, Ko Kung Chen, Sheng-Che Hung, Jia-Sheng Hong, Aichi Chien, Huai-Che Yang, Chun Shien Frank Wu, and Wei Fa Chu
- Subjects
Adult ,Intracranial Arteriovenous Malformations ,Male ,medicine.medical_specialty ,Time Factors ,Pulsatile flow ,Hemodynamics ,Pilot Projects ,030218 nuclear medicine & medical imaging ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,medicine.artery ,Carotid canal ,medicine ,Humans ,In patient ,Prospective Studies ,Aged ,business.industry ,Arteriovenous malformation ,General Medicine ,Middle Aged ,medicine.disease ,Cerebral Angiography ,medicine.anatomical_structure ,Point-of-Care Testing ,Rotational angiography ,Middle cerebral artery ,Arteriovenous Fistula ,Surgery ,Female ,Neurology (clinical) ,Radiology ,Internal carotid artery ,business ,030217 neurology & neurosurgery ,Blood Flow Velocity - Abstract
BackgroundTime-resolved rotational angiography (t-RA) enables interventionists to better comprehend complex arteriovenous malformations (AVMs), thereby facilitating endovascular treatment. However, its use in evaluating hemodynamic changes has rarely been explored.ObjectiveThis study uses t-RA to estimate intravascular flow in patients with AVM to compare this with flow in the normal population.MethodsPatients with available t-RA scans were prospectively categorized into one of three groups: hemorrhagic AVM, non-hemorrhagic AVM and control. Pulsatile time–density curves (TDCs) for C1, C6 and VOIMCA were used for amplitude and velocity estimation. C1 was at the cervical internal carotid artery (ICA), 2–3 cm below the carotid canal, C6 was at the paraclinoid segment of the ICA, and VOIMCA was at the junction of the first and second segment of the middle cerebral artery (MCA). A waveform amplitude ratio was defined as (peak − trough)/trough contrast intensity. VICA was defined as the distance between C6 and C1 divided by the time required for the wave to pass, and correspondingly, the average velocity of MCA (VMCA) was defined as the distance between C6 and VOIMCA divided by the duration for the same peak to travel from C6 and VOIMCA, AVM volume was estimated by MR angiography.ResultsAmplitude ratios AC1 and AC6, and average flow velocities VICA and VMCA were significantly larger in the non-hemorrhagic group than in the control group, while the hemorrhagic AVM group was not significantly different from the controls. VICA and VMCA showed moderate to good correlations with AVM volume (r=0.51 and 0.73, respectively). VMCA (33.0±9.1) was significantly lower than VICA (41.3±13.2) in the control group, but not in the two AVM groups.ConclusionTDC waveform propagation derived from t-RA can quantify hemodynamic differences between AVM and the control group. t-RA provides both real-time anatomic and hemodynamic evaluation, and can thus potentially improve the interventional workflow.
- Published
- 2017