Brain Arteriovenous Malformation: Future Prediction through Blood Flow Analysis Using Phase Contrast MRI

Abstract

Brain arteriovenous malformations (AVMs) are a major cause of hemorrhagic strokes; however, treating AVMs can be challenging. Identification and prediction of AVMs prone to rupture can help develop effective targeted treatments, which can improve patient outcomes. Stereotactic radiosurgery (SRS) is a minimally invasive standard treatment strategy for AVMs; however, its effects are not immediate, and there remains a risk of bleeding during the waiting period. Predicting the obliteration status of an AVM after SRS could enable guiding effective follow-up treatments. Phase contrast magnetic resonance imaging (PCMRI) is a non-invasive technique that utilizes phase shifts caused by applying magnetic fields of different polarities to measure fluid flow. In this review, we summarize findings from three studies conducted at our institution that performed PCMRI-based blood flow analysis. We focus on the relationship between AVM blood flow, hemorrhage, and treatment responsiveness. We also outline the current global status of this field. Recent advancements in PCMRI technology have lowered the barriers to its clinical application—the technique is increasingly used for elucidating the natural history of AVMs and optimizing treatment strategies. PCMRI is expected to enhance our understanding of and managing AVMs, particularly in improving prognostic predictions and treatment planning.