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Predictive value of MRI in diagnosing brain AVM recurrence after angiographically documented exclusion in children

American Journal of Neuroradiology Jul 12, 2019

Jhaveri A, et al. - Through 39 pediatric patients with brain AVMs during an 18-year period with angiographically documented obliteration post-treatment, the experts intended to discover the predictive values of contrast-enhanced MR imaging and TOF-MRA for brain AVM recurrence in comparison with conventional angiography and the role of 3D rotational angiography–MR imaging fusion in such cases. Out of 39 children, 13 had angiographically approved brain AVM recurrence, 8 after the surgery and 5 post-embolization. In all available cases, 3D rotational angiography–MR imaging fused images verified or eliminated recurrence. Embolization-only treatment was observed as a meaningful predictor of recurrence. MR imaging features auspicious of recurrence involved a tuft of vessels on TOF-MRA and nodular juxtamural/linear enhancement with a draining vein on contrast-enhanced MR imaging. hence, MR imaging was concluded as helpful for surveillance post-brain AVM treatment in children, but conventional angiography was needed for a definitive diagnosis of recurrence, nonetheless. Also, TOF-MRA and contrast-enhanced MR imaging presented complementary knowledge in order to ascertain brain AVM recurrence and should be evaluated in conjunction. Moreover, 3D rotational angiography–MR imaging fusion progressed the diagnostic confidence regarding brain AVM recurrence and therefore, was recommended for intraoperative neuronavigation.
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