Contribution of flow MRI in the therapeutic management of middle face high flow arteriovenous malformation: A case report - 05/09/19

Doi : 10.1016/j.jormas.2018.11.018

J. Bettoni ^a,^b,^c,^d,^⁎ , G. Pagé ^b,^c,^d, A.-V. Salsac ^e, J.-M. Constans ^c,^d,^f, J. Duisit ^g, C. Chivot ^h, S. Testelin ^a,^c,^d, B. Devauchelle ^a,^c,^d, O. Balédent ^b,^c,^d, S. Dakpé ^a,^c,^d
^a Maxillo-facial surgery department, centre hospitalo-universitaire d'Amiens, avenue Laennec, 80000 Amiens, France
^b BioFlowImage laboratory, université de Picardie Jules-Verne, avenue Laennec, 80000 Amiens, France
^c Facing faces institute, avenue Laennec, 80000 Amiens, France
^d EA CHIMERE, université de Picardie Jules-Verne, avenue Laennec, 80000 Amiens, France
^e Biomechanics and bioengineering laboratory (UMR CNRS 7338), université de technologie de compiègne-CNRS, Sorbonne universités, CS 60319, 60203 Compiègne, France
^f Radiology department, centre hospitalo-universitaire d'Amiens, avenue Laennec, 80000 Amiens, France
^g Department of plastic and reconstructive surgery, université catholique de Louvain-Clinique Universitaire, St-Luc avenue Hippocrate, 1200 Bruxelles, Belgium
^h Department of interventional radiology, Centre Hospitalo-Universitaire d'Amiens, avenue Laennec, 80000 Amiens, France

^⁎Correspondig author: Department of maxillo-facial surgery, university hospital of Amiens, avenue Laennec, 80000 Amiens, France.Department of maxillo-facial surgery, university hospital of Amiensavenue LaennecAmiens80000France

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Abstract

Backround

The radiosurgical management of high flow arteriovenous malformations (HFAVM) in the "destructive" stage requires a precise hemodynamic and anatomical assessment.

Patient and methods/case report

We report the case of a 32 years-old patient with a large ulcerated face HFAVM, on which Doppler ultrasound was impossible to perform. We show that, by combining 3D PCA and 2D CINE PC-MRI sequences, magnetic resonance imaging is capable to provide a complete morphometric and velocimetric mapping of the nidus and feeding arteries of the HFAVM.

Conclusion

Although Doppler ultrasound is the reference examination in the HFAVM, Flow MRI without contrast agent provides an advantageous alternative to assess vascular pathologies and choose the therapeutic strategy.

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Keywords : High flow arteriovenous malformation, Flow MRI, Phase contrast sequence, Without contrast agent, Therapeutic management