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Volume 12
Issue 4
10.3390/biomedicines12040753
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Review

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

by
Matteo De Simone
1,*,
Marco Maria Fontanella
2,
Anis Choucha
3,4,
Karl Schaller
5,
Paolo Machi
6,
Giuseppe Lanzino
7,
Philippe Bijlenga
5,
Felix T. Kurz
6,
Karl-Olof Lövblad
6 and
Lucio De Maria
2,5
1
Department of Medicine, Surgery and Dentistry “Scuola Medica Salernitana”, University of Salerno, Via S. Allende, 84081 Baronissi, Italy
2
Division of Neurosurgery, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Piazza Spedali Civili 1, 25123 Brescia, Italy
3
Department of Neurosurgery, Aix Marseille University, APHM, UH Timone, 13005 Marseille, France
4
Laboratory of Biomechanics and Application, UMRT24, Gustave Eiffel University, Aix Marseille University, 13005 Marseille, France
5
Division of Neurosurgery, Diagnostic Department of Clinical Neurosciences, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
6
Division of Interventional Neuroradiology, Department of Radiology and Medical Informatic, Geneva University Hospitals (HUG), Rue Gabrielle-Perret-Gentil 4, 1205 Geneva, Switzerland
7
Department of Neurosurgery and Interventional Neuroradiology, Mayo Clinic, 200 1st St SW, Rochester, MN 55905, USA
*
Author to whom correspondence should be addressed.
Biomedicines 2024, 12(4), 753; https://doi.org/10.3390/biomedicines12040753
Submission received: 27 February 2024 / Revised: 22 March 2024 / Accepted: 26 March 2024 / Published: 28 March 2024
(This article belongs to the Special Issue Advanced Research on Cerebrovascular Diseases)
Versions Notes

Abstract

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.
Keywords: ASL; AVM; DVA; arteriovenous shunting; NCE 4D MRA; 4D-S-PACK ASL; AVM; DVA; arteriovenous shunting; NCE 4D MRA; 4D-S-PACK

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MDPI and ACS Style

De Simone, M.; Fontanella, M.M.; Choucha, A.; Schaller, K.; Machi, P.; Lanzino, G.; Bijlenga, P.; Kurz, F.T.; Lövblad, K.-O.; De Maria, L. Current and Future Applications of Arterial Spin Labeling MRI in Cerebral Arteriovenous Malformations. Biomedicines 2024, 12, 753. https://doi.org/10.3390/biomedicines12040753

AMA Style

De Simone M, Fontanella MM, Choucha A, Schaller K, Machi P, Lanzino G, Bijlenga P, Kurz FT, Lövblad K-O, De Maria L. Current and Future Applications of Arterial Spin Labeling MRI in Cerebral Arteriovenous Malformations. Biomedicines. 2024; 12(4):753. https://doi.org/10.3390/biomedicines12040753

Chicago/Turabian Style

De Simone, Matteo, Marco Maria Fontanella, Anis Choucha, Karl Schaller, Paolo Machi, Giuseppe Lanzino, Philippe Bijlenga, Felix T. Kurz, Karl-Olof Lövblad, and Lucio De Maria. 2024. "Current and Future Applications of Arterial Spin Labeling MRI in Cerebral Arteriovenous Malformations" Biomedicines 12, no. 4: 753. https://doi.org/10.3390/biomedicines12040753

APA Style

De Simone, M., Fontanella, M. M., Choucha, A., Schaller, K., Machi, P., Lanzino, G., Bijlenga, P., Kurz, F. T., Lövblad, K.-O., & De Maria, L. (2024). Current and Future Applications of Arterial Spin Labeling MRI in Cerebral Arteriovenous Malformations. Biomedicines, 12(4), 753. https://doi.org/10.3390/biomedicines12040753

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