Head US provides limited information on intracranial aneurysm, but Doppler US may be used to confirm the vascular nature of a mass seen on head US performed in neonates and young infants with open fontanels. CT Head Unenhanced head CT is useful in hemorrhagic high-flow vascular anomalies to assess the location and size of hemorrhage, evidence of mass effect, and hydrocephalus [59]. High-flow vascular malformations that have not bled are slightly hyperdense relative to brain on unenhanced head CT. The detection of a high-flow vascular anomaly that has not bled may be improved with the use of IV contrast. CTA Head CTA is often used to delineate the anatomy of a high-flow vascular anomaly but lacks the temporal information available from catheter angiography. CTA may be used to monitor the lesion prior to treatment or to assess for growth or recurrence after treatment. MRI Head MRI is used to determine the location and size of high-flow vascular anomalies and is often preferred to CT for use in children. SWI and arterial spin-labeling imaging may improve the delineation of the draining veins and arteriovenous shunting, respectively, compared with conventional MRI sequences [24]. Contrast may be required to demonstrate small malformations. MRA Head MRA, like CTA, can be used to delineate the anatomy of a high-flow vascular anomaly but lacks the temporal information available from catheter angiography. MRA is often preferable to CTA in children for following vascular anomalies serially. The use of IV contrast may be required to assess the venous outflow of the anomaly. MRA may be used to monitor the anomaly prior to treatment or to assess for growth or recurrence after treatment. Arteriography Cervicocerebral With the increased accuracy of the noninvasive imaging studies CTA and MRA, catheter angiography is not typically used as the initial diagnostic imaging for suspected high-flow vascular anomaly.
Cerebrovascular Disease Child PCAs. Head US provides limited information on intracranial aneurysm, but Doppler US may be used to confirm the vascular nature of a mass seen on head US performed in neonates and young infants with open fontanels. CT Head Unenhanced head CT is useful in hemorrhagic high-flow vascular anomalies to assess the location and size of hemorrhage, evidence of mass effect, and hydrocephalus [59]. High-flow vascular malformations that have not bled are slightly hyperdense relative to brain on unenhanced head CT. The detection of a high-flow vascular anomaly that has not bled may be improved with the use of IV contrast. CTA Head CTA is often used to delineate the anatomy of a high-flow vascular anomaly but lacks the temporal information available from catheter angiography. CTA may be used to monitor the lesion prior to treatment or to assess for growth or recurrence after treatment. MRI Head MRI is used to determine the location and size of high-flow vascular anomalies and is often preferred to CT for use in children. SWI and arterial spin-labeling imaging may improve the delineation of the draining veins and arteriovenous shunting, respectively, compared with conventional MRI sequences [24]. Contrast may be required to demonstrate small malformations. MRA Head MRA, like CTA, can be used to delineate the anatomy of a high-flow vascular anomaly but lacks the temporal information available from catheter angiography. MRA is often preferable to CTA in children for following vascular anomalies serially. The use of IV contrast may be required to assess the venous outflow of the anomaly. MRA may be used to monitor the anomaly prior to treatment or to assess for growth or recurrence after treatment. Arteriography Cervicocerebral With the increased accuracy of the noninvasive imaging studies CTA and MRA, catheter angiography is not typically used as the initial diagnostic imaging for suspected high-flow vascular anomaly.