Feasibility of Time-Resolved MR Angiography for Detecting Recanalization of Pulmonary Arteriovenous Malformations Treated with Embolization with Platinum Coils |
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| Affiliation: | 1. Department of Radiology, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601 Japan;2. Division of Central Radiology, Nagoya City University Hospital, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601 Japan;1. School of Radiology, Università degli Studi di Milano, Via Antonio di Rudinì, 8, 20142 Milano, Italy;2. Department of Radiology Interventistica, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Clinico Humanitas, Rozzano, Italy;1. Department of Interventional Radiology, First Affiliated Hospital of Soochow University, 188 Shizi St., 215006 Suzhou, China;2. Department of Radiology, Changhai Hospital, Shanghai, China;3. Division of Neurosurgery, Department of Surgery, Taipei Cathay General Hospital, Taipei, Taiwan;4. School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan;1. Department of Radiology, National Hospital Organization Beppu Medical Center, Oita, Japan;2. Department of Radiology, Kyushu University Beppu Hospital, 4546 Tsurumihara, Beppu 874-0838, Japan;3. Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University Hospital, Fukuoka, Japan |
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| Abstract: | PurposeTo assess the feasibility of time-resolved magnetic resonance (MR) angiography as a follow-up method after embolization for pulmonary arteriovenous malformations (PAVMs).Materials and MethodsEvaluation of 28 PAVMs in 10 patients previously treated with embolization with platinum coils was performed. The mean observation period after embolization was 49 months. All patients underwent unenhanced chest computed tomography (CT) and time-resolved MR angiography followed by transcatheter digital subtraction angiography within 5 weeks for a definite diagnosis. Two radiologists reviewed the CT and time-resolved MR angiography findings using a blinded method. On CT, the draining veins of the PAVMs were measured before and after embolization, and shrinkage rates were calculated. On time-resolved MR angiography, recanalization was diagnosed when the draining vein or aneurysmal sac or both were enhanced in the pulmonary arterial phase. Correlations between recanalization, the shrinkage rate of the draining vein, and the diagnostic accuracies of CT and time-resolved MR angiography were assessed and compared with digital subtraction angiography.ResultsFive lesions could not be measured on CT because of metallic artifacts. The mean shrinkage rates of the draining vein for recanalized and occluded PAVMs were 23% ± 19 (SD) for recanalized PAVMs and 47% ± 21 for occluded PAVMs (P = .001). The sensitivity and specificity were 93% and 53%, respectively, when the shrinkage rate threshold was set to 50%. On time-resolved MR angiography, the sensitivity and specificity were 93% and 100%, respectively, for Reader 1 and 100% and 93%, respectively, for Reader 2. The κ coefficient was 0.86.ConclusionsTime-resolved MR angiography appears to be a feasible method for PAVM follow-up examinations and to provide a more accurate diagnosis of recanalization compared with unenhanced CT. |
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