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Review
. 2022 Jun 9;14(6):e25803.
doi: 10.7759/cureus.25803. eCollection 2022 Jun.

A Systematic Review Comparing Digital Subtraction Angiogram With Magnetic Resonance Angiogram Studies in Demonstrating the Angioarchitecture of Cerebral Arteriovenous Malformations

Aishwarya Raman  1 , Manish Uprety  1 , Maria Jose Calero  2 , Maria Resah B Villanueva  3 , Narges Joshaghani  4 , Nicole Villa  1 , Omar Badla  5 , Raman Goit  1 , Samia E Saddik  6 , Sarah N Dawood  7 , Ahmad M Rabih  1 , Ahmad Mohammed  3 , Tharun Yadhav Selvamani  5 , Jihan Mostafa  1
Affiliations
Review

A Systematic Review Comparing Digital Subtraction Angiogram With Magnetic Resonance Angiogram Studies in Demonstrating the Angioarchitecture of Cerebral Arteriovenous Malformations

Aishwarya Raman et al. Cureus. .

Abstract

In brain arteriovenous malformations (AVMs), there is mismatched communication between arteries and veins, causing a nidal bed between them. This systematic review explores whether a magnetic resonance angiogram (MRA) can be used as a diagnostic imaging tool instead of a digital subtraction angiogram (DSA). Utilizing PubMed, Cochrane, and Google Scholar, as well as the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for article selection, a literature search was conducted over the past five years. Eleven studies were included, with a majority of the articles suggesting a potential for consideration. Arterial spin labeling (ASL) versus time-of-flight (TOF) scans was a comparison study, in addition to the study on pseudo-continuous arterial spin labeling (pc-ASL), which proved its high sensitivity in comparison with DSA scans. Other studies included quantitative magnetic resonance angiogram (Q-MRA) measuring the blood flow and susceptibility weighted imaging (SWI) modality. Although promising, digital subtraction angiogram (DSA) scans have diagnostic superiority. In addition, articles discussed follow-up magnetic resonance angiogram (MRA) scans after surgery. Overall, digital subtraction angiogram remains the gold standard due to its superior spatial resolution and hemodynamic properties; these are the key limitations of magnetic resonance studies. MRA has demonstrated its ability to reproduce high-quality diagnostic images for arteriovenous malformation (AVM) angioarchitecture; however, coupled with their limitations, not many studies with large sample sizes over longer periods have been conducted, and we urge more research into it.

Keywords: 4d dsa; asl-mra; avm; brain avm; dsa; mra; swi; tof-mra.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA flow diagram detailing the study selection process
Figure 2
Figure 2. Retrospective study on quantitative MRA imaging scan reporting the time density time (TT) and its subcategories in comparison to AVM hemodynamics
TT: time density time, AVM: arteriovenous malformation
See this image and copyright information in PMC

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