BACKGROUND:MR digital subtraction angiography (MR-DSA) is a contrast-enhanced MR angiographic sequence that enables time-resolved evaluation of the cerebral circulation. OBJECTIVE:We describe the feasibility and technical success of our attempts at MR-DSA for the assessment of intracranial pathology in children. MATERIALS AND METHODS:We performed MR-DSA in 15 children (age range 5 days to 16 years) referred for MR imaging because of known or suspected intracranial pathology that required a dynamic assessment of the cerebral vasculature. MR-DSA consisted of a thick (6-10 mm) slice-selective RF-spoiled fast gradient-echo sequence (RF-FAST) acquired before and during passage of an intravenously administered bolus of Gd-DTPA. The images were subtracted and viewed as a cine loop. RESULTS:MR-DSA was performed successfully in all patients. High-flow lesions were shown in four patients; these included vein of Galen aneurysmal malformation, dural fistula, and two partially treated arteriovenous malformations (AVMs). Low-flow lesions were seen in three patients, all of which were tumours. Normal flow was confirmed in eight patients including two with successfully treated AVMs, and in three patients with cavernomas. CONCLUSION:Our early experience suggests that MR-DSA is a realistic, non-invasive alternative to catheter angiography in certain clinical settings.

译文

背景:MR数字减影血管造影(MR-DSA)是一种对比增强的MR血管造影序列,可对脑循环进行时间分辨评估。
目的:我们描述了MR-DSA评估儿童颅内病理的尝试的可行性和技术成功。
材料与方法:由于已知或怀疑颅内病理需要动态评估脑血管系统,我们对15例接受MR成像的儿童(年龄范围5天至16岁)进行了MR-DSA检查。 MR-DSA由厚的(6-10 mm)切片选择性RF破坏的快速梯度回波序列(RF-FAST)组成,在静脉内给予Gd-DTPA推注之前和期间均已获得。减去图像并将其视为电影循环。
结果:所有患者均成功进行了MR-DSA检查。四名患者出现高流量病灶。其中包括Galen动脉瘤畸形静脉,硬脑膜瘘和两个经过部分治疗的动静脉畸形(AVM)。在三名患者中均发现了低流量病变,所有这些都是肿瘤。在八名患者中确认了正常血流,其中包括两名成功治疗过的AVM和三名患有海绵状瘤的患者。
结论:我们的早期经验表明,在某些临床情况下,MR-DSA是导管血管造影术的一种现实的,非侵入性的替代方法。

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