Purpose: To define the appearance of peripheral vascular malformations
at magnetic resonance angiography (MRA) and assess the role of magnet
ic resonance imaging (MRI) and MRA in the investigation of these lesio
ns, Patients and methods: Fourteen patients (aged 8-51 years) with cli
nical evidence of a vascular malformation were referred for MRI and MR
A, performed on a 0.5T GE Vectra superconducting system (International
General Electric, Slough, UK), Multisection T1-weighted spin-echo and
T2-weighted fast spin-echo pulse sequences were performed, with an in
version recovery fast spin-echo sequence in two cases, Two-dimensional
time of Eight (2-D TOF) and/or 2-D phase contrast (PC) MRA was perfor
med in 13 cases, Eleven patients had digital subtraction angiography (
DSA) using a Phillips Integris V3000 digital angiographic unit, The fi
ndings at MRA and MRI were compared with the catheter angiograms, and
the effective diagnostic input of MRA and MRI was determined, Results:
MRA demonstrated major feeding vessels and multiple intra-lesional ve
ssels in relation to the high flow lesions, features absent in the lon
flow lesions, However, small feeding vessels to the AVMs were not cle
arly identified, MRI gave a clear demonstration of the anatomical exte
nt of all lesions, AVMs (it = 6) and venous malformations (it = 6) wer
e reliably distinguished, the former containing multiple serpentine si
gnal voids on T1- and T2-weighted imaging, the latter being hyperinten
se to fat on T2-weighted images, Two other high-flow lesions diagnosed
clinically as vascular malformations appeared solid on R IRI, and mer
e diagnosed histologically as a carotid body tumour and an angiomyolip
oma, Conclusion: Although 2-D TOF MRA can distinguish AVMs from venous
malformations, the technique adds little extra practical information
to the diagnostic process, and cannot compete with catheter angiograph
y for the detailed demonstration of AVM feeding vessels, These lesions
can also be characterized using spin-echo sequences, though the prima
ry role of MRI is to demonstrate their anatomical extent.