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Typically, only high field systems are equipped with stronger gradients and short RF pulse designs, a must for high temporal resolution that are also responsible for high SAR, high susceptibility as well as neurostimulation. Gradient induced image noise tends to be high at 3T. Often vendors try to ameliorate such increased image noise with multi-channel head arrays and aggressive filter designs allowing an appearance of high SNR and CNR quality; however, the achievable SNR and CNR in the AVM remain limited as the analyzed articles by Zhuo et al seem to have in common. A short term solution to harvest advantages of high fields with acceptable T2* loss may be to use fast 3D shimming to generate a high degree of homogeneity in the operator selected AVM tissue. In addition, to avoid susceptibility increase at high fields by the contrast pooled into neovasculature, not only for AVM but also for other vascular imaging applications, improved CM design need to accompany any such robust shimming routines. Until that and more are achieved, DSA may retain its superiority in the follow-ups of treated AVMs.


This is the author's accepted manuscript of an article originally published in European Radiology, available at

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