RT Journal Article
SR Electronic
T1 Simultaneous Multiparametric Estimation of Arteriovenous Malformations Hemodynamics Using MR Fingerprinting ASL (MRF-ASL)
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP ajnr.A8806
DO 10.3174/ajnr.A8806
A1 Hu, Zhiyi
A1 Jiang, Dengrong
A1 Shi, Wen
A1 Salim, Hamza A.
A1 Lakhani, Dhairya A.
A1 Xu, Risheng
A1 Huang, Judy
A1 Nael, Kambiz
A1 Lu, Hanzhang
A1 Yedavalli, Vivek
YR 2025
UL http://www.ajnr.org/content/early/2025/04/15/ajnr.A8806.abstract
AB BACKGROUND AND PURPOSE: Accurate hemodynamic characterization of cerebral AVMs is critical for treatment planning, risk stratification, and post-treatment monitoring but remains challenging due to their abnormal angioarchitecture. MR-fingerprinting (MRF) arterial-spin-labeling (ASL) is a novel, non-invasive technique that enables simultaneous quantification of cerebral blood flow (CBF), arterial cerebral blood volume (aCBV), and bolus arrival time (BAT) within a single 5-minute scan. This study evaluates the feasibility of MRF-ASL in assessing AVM hemodynamics and compares its sensitivity for AVM detection with CBF measurements obtained using single-delay pseudo-continuous ASL (pCASL).MATERIALS AND METHODS: Patients with DSA-confirmed AVMs were scanned on a 3T MRI system. Imaging protocols included MRFASL, standard single-delay pCASL, and T2-weighted MRI. MRF-ASL simultaneously derived CBF, aCBV, and BAT, with CBF estimated using two kinetic models: a one-compartment model, which reflects combined tissue and arterial contributions, and a two-compartment model, which separates arterial signal from tissue perfusion. ROIs were manually drawn over the AVM nidus and contralateral non-affected tissue. MRF-ASL parameters and pCASL-derived CBF were compared between the AVM nidus and non-affected tissue. Additionally, linear regression analyses were conducted to examine the relationships between MRF-ASL parameters, single-delay pCASL CBF, and the Spetzler-Martin (SM) grade.RESULTS: Six AVM patients with SM grades ranging from 1 to 5 were included in this study. MRF-ASL parameters revealed significantly elevated CBF1-compartment (AVM 129.3±21.5ml/100g/min vs. non-affected 51.6±23.9ml/100g/min, P=0.03), CBF2-compartment (AVM 109.8±24.4ml/100g/min vs. non-affected 36.6±18.6ml/100g/min, P=0.03), aCBV (AVM 7.0±4.5% vs. non-affected 0.6±0.4%, P=0.03), and shortened BAT (AVM 784±337ms vs. non-affected 1099±500ms, P=0.03) in AVM nidus compared to contralateral non-affected tissue in the same patient. In contrast, no significant difference was observed for pCASL CBF (AVM 47.5±49.2ml/100g/min vs. non-affected 39.4±14.0ml/100g/min, P=0.44). A significant positive correlation was identified between SM grade and both CBF2-compartment (P=0.006) and aCBV (P=0.005). No association was found for CBF1-compartment (P=0.12), BAT (P=0.15), or pCASL CBF (P=0.13).CONCLUSIONS: In our preliminary study, MRF-ASL has the potential to provide comprehensive and multiparametric evaluation of AVM hemodynamics, demonstrating superior sensitivity for detecting AVM abnormalities compared to single-delay pCASL. These findings show the feasibility of MRF-ASL as a potentially useful tool for non-invasive characterization and monitoring of AVMs.ABBREVIATIONS: MRF = MR Fingerprinting; ASL = arterial spin labeling; pCASL = pseudo-continuous arterial spin labeling; aCBV = arterial cerebral blood volume; BAT = bolus arrival time; SM = Spetzler-Martin.