(a) Coronal STIR image demonstrating a large AVM with multiple large tortuous flow voids involving the vastus medialis and intermedius muscles; (b) coronal MIP image of dynamic MRA (TWIST) in the early arterial phase delineating four arterial feeders arising from the proximal, mid and distal SFA (solid arrows), with early enhancement of the AVM; (c) Subsequent MRA MIP image in the arterial phase demonstrating avid enhancement of the AVM with a large draining venous channel (solid arrows), multiple smaller venous channels and early filling of the distal SFV; (d) Coronal ASL image demonstrating two discrete foci of hyperintensity within the AVM (solid arrows), suggestive of the nidus through which blood flow is maximal; (e) Axial ASL image again highlighting the two foci of intense signal suggestive of the nidus (solid arrows). At the same level, there is another focus of less marked high signal posteriorly indicating early venous drainage (solid arrowhead); (f) Axial ASL image acquired at another slice identifying one of the superior arterial feeders (solid arrow). ASL, arterial spin labeling; AVM, arteriovenous malformation; MIP, maximum image projection; SFA, superficial artery; SFV, superficial vein; STIR, short tau inversion recovery.
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