Radiology, Vol 180, 785-791, Copyright © 1991 by Radiological Society of North America

ARTICLES

Persistent nidus blood flow in cerebral arteriovenous malformation after stereotactic radiosurgery: MR imaging assessment

RG Quisling, KR Peters, WA Friedman and RP Tart
Department of Radiology, University of Florida Medical Center, Shands Hospital, Gainesville 32610.

Stereotactic radiosurgery has become a major force in the treatment of arteriovenous malformations (AVMs) of the brain. After treatment, obliteration of flow through the malformation occurs in 75%-85% of cases within 2 years, assuming the entire AVM nidus can be encompassed by the radiation field. Because the follow-up period is relatively long, a noninvasive means to assess residual transnidus blood flow is desirable. The authors report favorable findings after a comparative analysis of 85 posttreatment magnetic resonance images and 27 follow-up cerebral arteriograms in 34 patients treated with stereotactic radiosurgery. The authors found that transnidus flow can be determined from apparent signal intensity differences between tandem two- dimensional gradient-recalled echo images obtained first without and then with gradient moment nulling (flow compensation), with empirically derived pulse parameters. This method provides a means to monitor the reduction in AVM matrix size and to assess the extent of persistent arteriovenous shunting (ie, blood flow) across the nidus.

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