13th Annual Global Embolization Symposium & Technologies
Purpose : To evaluate the accuracy of TRICKS-MRA in defining the anatomy and characterizing the functional arterial and venous components of AVM of head and neck, using catheter digital subtraction angiography (DSA) performed at time of treatment as reference.
Material and Methods : From 1/1/17 to 28/2/18 11 patients with AVM of head and neck (6 males, 5 females, mean age 31) underwent MRI evaluation with our protocol, which included TRICKS sequences, for definition of the anatomy and for treatment planning by a multidisciplinary team, and subsequently underwent combined endovascular and surgical treatment. 3 experienced interventional radiologists classified the MR studies according to image quality, using a scale ranging from 1 to 3 points, and diagnostic accuracy both in the characterization of the arterial and venous components of the, malformations and in defining their high or low-flow nature, using catheter DSA performed at time of treatment as reference.
Results : Mean image quality scoring resulted 2.8. DSA confirmed in all cases the distinction of the arterial and venous components of the AVMs as described by TRICKS-MRI (mean diagnostic accuracy 100%). In 90% the high or low-flow nature of the AVMs described by MRI was confirmed by DSA very important to plan the treatment (endovascular alone vs endovascular combined with surgery).
Conclusions : In our experience TRICKS-MRA resulted an accurate means for carachterization of AVMs, distinguishing their arterial and venous components. Moreover defining AVM flow it can be very useful in treatment planning which are fundamental for the correct treatment planning.