Four-dimensional computed tomography angiography is valuable in intracranial dural arteriovenous fistula diagnosis and fistula evaluation

Acta Neurol Belg. 2015 Sep;115(3):303-9. doi: 10.1007/s13760-014-0387-7. Epub 2014 Oct 30.

Abstract

This study was to evaluate the value of four-dimensional computed tomography angiography (4D-CTA) in the diagnosis of intracranial dural arteriovenous fistula (DAVF). This study included 16 patients who were diagnosed to have intracranial DAVF by digital subtraction angiography (DSA). The 4D-CTA was performed by Aquilion ONE multi-detector CT scanner (Toshiba Medical Systems, Japan) equipped with 320 × 0.5 mm detector rows. Standard biplane fluoroscopy equipments (Infinix, Toshiba Medical Systems, Japan and ADVANTX LC/LP, GE Medical Systems, Milwaukee, WI, USA) were applied in the diagnosis of intra-arterial DSA. Examinations were performed to evaluate the findings of DSA and 4D-CTA in each patient. The examination results were read by two independent readers in a blind manner. All results were documented on standardized scoring sheets. In all 16 cases, the same diagnosis results of intracranial DAVF were obtained from DSA and 4D-CTA. The results of subtype (Borden and Cognard classification), venous reflux and fistula sites were also accurately exhibited in 4D-CTA. In addition, there was a little discrepancy in identifying smaller and specific arterial branches and in distinguishing fistula type (focal or diffuse) using 4D-CTA. Good-to-excellent agreements were made between 4D-CTA and DSA. Therefore, 4D-CTA could be a feasible tool for the characterization of intracranial DAVF, with respect to determining fistula site and venous drainage.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Central Nervous System Vascular Malformations / diagnostic imaging*
  • Cerebral Angiography / methods*
  • Female
  • Four-Dimensional Computed Tomography / methods*
  • Humans
  • Male
  • Middle Aged
  • Radiographic Image Interpretation, Computer-Assisted
  • Young Adult