Arteriovenous Malformation - Vascular Lesions

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How Are AVMs and Other Vascular Lesions Detected?

Physicians now use an array of traditional and new imaging technologies to uncover the presence of AVMs. Angiography provides the most accurate pictures of blood vessel structure in AVMs. The technique requires injecting a special water-soluble dye, called a contrast agent, into an artery. The dye highlights the structure of blood vessels so that it can be recorded on conventional X-rays. Although angiography can record fine details of vascular lesions, the procedure is somewhat invasive and carries a slight risk of causing a stroke. Its safety, however, has recently been improved through the development of more precise techniques for delivering dye to the site of an AVM. Superselective angiography involves inserting a thin, flexible tube called a catheter into an artery; a physician guides the tip of the catheter to the site of the lesion and then releases a small amount of contrast agent directly into the lesion.

Two of the most frequently employed noninvasive imaging technologies used to detect AVMs are computed axial tomography (CT) and magnetic resonance imaging (MRI) scans. CT scans use X-rays to create a series of cross-sectional images of the head, brain, or spinal cord and are especially useful in revealing the presence of hemorrhage. MRI imaging, however, offers superior diagnostic information by using magnetic fields to detect subtle changes in neurological tissues. A recently developed application of MRI technology -- magnetic resonance angiography (MRA) -- can record the pattern and velocity of blood flow through vascular lesions as well as the flow of cerebrospinal fluid throughout the brain and spinal cord. CT, MRI, and MRA can provide three-dimensional representations of AVMs by taking images from multiple angles.

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