Article Dans Une Revue Biomedicines Année : 2024

Current and Future Applications of Arterial Spin Labeling MRI in Cerebral Arteriovenous Malformations

Matteo de Simone
Marco Maria Fontanella
Anis Choucha
Karl Schaller
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  • PersonId : 1509947
Paolo Machi
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  • PersonId : 1509948
Giuseppe Lanzino
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Philippe Bijlenga
Felix T Kurz
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Karl-Olof Lövblad
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Lucio de Maria

Résumé

Arterial spin labeling (ASL) has emerged as a promising noninvasive tool for the evaluation of both pediatric and adult arteriovenous malformations (AVMs). This paper reviews the advantages and challenges associated with the use of ASL in AVM assessment. An assessment of the diagnostic workup of AVMs and their variants in both adult and pediatric populations is proposed. Evaluation after treatments, whether endovascular or microsurgical, was similarly examined. ASL, with its endogenous tracer and favorable safety profile, offers functional assessment and arterial feeder identification. ASL has demonstrated strong performance in identifying feeder arteries and detecting arteriovenous shunting, although some studies report inferior performance compared with digital subtraction angiography (DSA) in delineating venous drainage. Challenges include uncertainties in sensitivity for specific AVM features. Detecting AVMs in challenging locations, such as the apical cranial convexity, is further complicated, demanding careful consideration due to the risk of underestimating total blood flow. Navigating these challenges, ASL provides a noninvasive avenue with undeniable merits, but a balanced approach considering its limitations is crucial. Larger-scale prospective studies are needed to comprehensively evaluate the diagnostic performance of ASL in AVM assessment.

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Neurobiologie
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hal-04955754 , version 1 (19-02-2025)

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Matteo de Simone, Marco Maria Fontanella, Anis Choucha, Karl Schaller, Paolo Machi, et al.. Current and Future Applications of Arterial Spin Labeling MRI in Cerebral Arteriovenous Malformations. Biomedicines, 2024, 12 (4), pp.753. ⟨10.3390/biomedicines12040753⟩. ⟨hal-04955754⟩
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