Diagnostic value of high spatial and temporal resolution time-resolved MR angiography in the workup of peripheral high-flow vascular malformations at 1.5 Tesla

To evaluate the feasibility and diagnostic impact of time-resolved MR angiography (TR-MRA) combined with parallel imaging and low contrast dose for the assessment of peripheral high-flow vascular malformations (VM) at 1.5 Tesla (T). Twelve consecutive patients (7 female, 5 male, mean age 24.7 ± 11.1 years) with known or suspected high-flow VM underwent time-resolved MRA. Two readers individually assessed image quality, diagnostic confidence as well as hemodynamic features. Digital subtraction angiography (DSA) correlation was available in 9 patients. TR-MRA provided a comprehensive assessment of all VMs with good quality images, allowing reliable differentiation of the early and main arterial phases and of at least the early venous phase. Based on hemodynamic features VM were classified as predominantly arterial malformations in 5 cases (42%), or arteriovenous malformations in the remaining 7 cases (58%). The high-flow component of a VM was confirmed by DSA in 9/9 (100%) cases during the interventional treatment procedure. TR-MRA of peripheral VMs with temporal interpolation and stochastic spiral trajectories is feasible, allowing the assessment of dynamic inflow and vessel-specific information similar to conventional DSA. Therefore, TR-MRA represents a reasonable alternative imaging technique for the pre-treatment evaluation of high-flow VMs.