Cerebral arteriovenous malformation

Complex 3D hemodynamics and 3D blood flow alterations during staged embolization

Michael Markl, Can Wu, Michael C. Hurley, Sameer A. Ansari, Timothy J. Carroll, Rudy J. Rahme, Salah G. Aoun, James Carr, Hunt Batjer, Bernard Bendok

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Complex hemodynamics in cerebral arteriovenous malformations (AVM) are thought to play a key role in their pathophysiology. We applied 4D flow magnetic resonance imaging (MRI) for the detailed evaluation of AVM function at baseline and to investigate the impact of staged embolization on AVM hemodynamics in a patient with a Spetzler-Martin grade III AVM. The patient underwent three embolization procedures resulting in >50% nidal casting and obliteration of several arteriovenous fistulae. 4D flow MRI demonstrated highly complex 3D hemodynamics at baseline and revealed intricate arterial feeding, a large vascularized nidus with high variability in regional blood flow velocities, and clearly visible venous drainage with high flow velocities above 50 cm/s. 3D blood flow visualization and quantification during follow-up illustrated the systemic impact of focal embolization on cerebral hemodynamics resulting in compaction of the AVM, redistribution of blood flow velocities, and altered peak flow velocities and blood flow in multiple vascular territories. 4D flow MRI may offer a useful noninvasive tool to help to identify subtleties and nuances of the quantitative hemodynamic alterations in AVM vascular architecture as a supplement to established imaging modalities.

Original languageEnglish (US)
Pages (from-to)946-950
Number of pages5
JournalJournal of Magnetic Resonance Imaging
Volume38
Issue number4
DOIs
StatePublished - Oct 2013
Externally publishedYes

Fingerprint

Intracranial Arteriovenous Malformations
Arteriovenous Malformations
Blood Flow Velocity
Hemodynamics
Magnetic Resonance Imaging
Blood Vessels
Arteriovenous Fistula
Regional Blood Flow
Drainage

Keywords

  • 4D flow MRI
  • AVM
  • hemodynamics
  • MRI
  • staged embolization

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Cerebral arteriovenous malformation : Complex 3D hemodynamics and 3D blood flow alterations during staged embolization. / Markl, Michael; Wu, Can; Hurley, Michael C.; Ansari, Sameer A.; Carroll, Timothy J.; Rahme, Rudy J.; Aoun, Salah G.; Carr, James; Batjer, Hunt; Bendok, Bernard.

In: Journal of Magnetic Resonance Imaging, Vol. 38, No. 4, 10.2013, p. 946-950.

Research output: Contribution to journalArticle

Markl, M, Wu, C, Hurley, MC, Ansari, SA, Carroll, TJ, Rahme, RJ, Aoun, SG, Carr, J, Batjer, H & Bendok, B 2013, 'Cerebral arteriovenous malformation: Complex 3D hemodynamics and 3D blood flow alterations during staged embolization', Journal of Magnetic Resonance Imaging, vol. 38, no. 4, pp. 946-950. https://doi.org/10.1002/jmri.24261
Markl, Michael ; Wu, Can ; Hurley, Michael C. ; Ansari, Sameer A. ; Carroll, Timothy J. ; Rahme, Rudy J. ; Aoun, Salah G. ; Carr, James ; Batjer, Hunt ; Bendok, Bernard. / Cerebral arteriovenous malformation : Complex 3D hemodynamics and 3D blood flow alterations during staged embolization. In: Journal of Magnetic Resonance Imaging. 2013 ; Vol. 38, No. 4. pp. 946-950.
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