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Figures
- Fig 1.
Conventional angiography of a left temporal lobe AVM. Early arterial phases show primarily MCA supply (arrow) on a left frontal oblique left ICA injection (A), with secondary posterior cerebral artery supply via a small branch artery (arrow) on a lateral left vertebral artery injection (B). Late arterial phase (C) shows early opacification of the left basal vein of Rosenthal, the exclusive venous drainage (arrow).
- Fig 2.
Conventional 3D time-of-flight MRA (upper row) and 4D Flow MRI (lower row) during a 20-month follow-up course after SRS. Scans were acquired at 1 (A and D), 6 (E), 12 (B and F), and 20 (C and G) months following SRS (MRA was not performed at the 6-month follow-up). Conventional sequences show a gradual decrease in size of the left temporal lobe AVM nidus, with decreasing distention of the draining vein (thin white arrow). 4D Flow MRI 1 month after SRS (D) shows asymmetrically greater flow in the left MCA (thick red arrow) and posterior cerebral artery feeding vessels (thick white arrow), as well as in the distended draining vein. The left MCA flow velocity gradually decreases with time (D–G).
- Fig 3.
Blood flow in the anterior circulation (A) and draining vein (B) measured by 4D Flow over a 20-month follow-up after SRS. At the 6-month follow-up, arterial flow decreased most dramatically in the left MCA. Flow in the left MCA, left ICA, and draining vein continued to decrease throughout the posttreatment course.
Tables
4D Flow MRI acquisition parameters
Parameter Contrast volume 15–20 mL of gadobenic acid Voxel size 1.12 × 0.98 × 1.60 to 1.16 × 1.02 × 1.80 mm Flip angle 15° TR 4.96–5.05 sec TE 2.40–2.57 ms Scan time 7 min 45 sec to 9 min 3 sec Velocity encoding 100–200 cm/s Bandwidth 62 kHz
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