Evaluation of Intracranial Arteriovenous Malformations With Four-Dimensional Arterial-Spin Labeling Based 3-T Magnetic Resonance Angiography

Objective We aimed to assess the usefulness of 3-T 4-dimensional (4D) arterial spin-labeling (ASL)-based magnetic resonance angiography (MRA) with color-coded time-of-arrival (TOA) maps for the evaluation of cerebral arteriovenous malformations (AVMs). Methods Our study included 6 patients with cerebral AVMs. They underwent 4D-ASL MRA at 3T and digital subtraction angiography. A pseudocontinuous arterial spin labeling protocol with look-locker sampling was used for spin labeling. Two independent readers reviewed the 4D-ASL MRA images with color-coded TOA maps for the nidus size, arterial feeders, and venous drainage. Two other readers consensually reviewed the digital subtraction angiography images. Results The cerebral AVMs were demonstrated on all 4D-ASL MRA images. In 5 high-flow AVMs, the color-coded TOA maps were especially useful for identifying the feeder/drainer. Intermodality agreement was excellent for the nidus size ( = 1.0), very good for arterial feeders ( = 0.88), and good for venous drainage ( = 0.80). Conclusions The 4D-ASL 3-T MRA with color-coded TOA maps is useful for assessing the gross angiographic characteristics of intracranial AVMs.