Sensitivity of CT angiography, T2-weighted MRI, and magnetic resonance angiography in detecting cerebral arteriovenous malformations and associated aneurysms

Abstract

An increasing number of patients with arteriovenous malformations (AVM) are being screened with expedient, safe, and non-invasive methods such as computed tomography angiography (CTA), MRI, and magnetic resonance angiography (MRA). Only a paucity of small series have examined the sensitivity of these modalities in detecting AVMs. In this study, we reviewed 125 patients with AVMs, demonstrating overall sensitivities of 90% for CTA, 89% for T2-weighted MRI, and 74% for MRA. The greater sensitivity of CTA in detecting AVMs compared to MRA did meet statistical significance (pCTA, MRA=0.036). For unruptured AVMs, the sensitivities were 96%, 97% and 71% (pCTA, MRA=0.043) and for ruptured AVMs, they were 87%, 83% and 77%, respectively. The sensitivity was 100% for both CTA and T2-weighted MRI for AVMs larger than 3cm. Importantly, associated aneurysms were best detected via CTA, with a sensitivity of 88%, as compared to 29% for MRI and 27% for MRA (pCTA, MRA=1.2×10−6), with the greatest distinction occurring within the subgroup of intranidal aneurysms with a sensitivity of 83% for CTA compared to 0% for both MRI and MRA (pCTA, MRA=0.005).