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Eur J Radiol. 2015 Jun;84(6):1144-9. doi: 10.1016/j.ejrad.2015.03.009. Epub 2015 Mar 18.

Four-dimensional computed tomography angiographic evaluation of cranial dural arteriovenous fistula before and after embolization.

Author information

1
Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No. 168 Changhai Road, Shanghai, China. Electronic address: bing.tian@hotmail.com.
2
Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No. 168 Changhai Road, Shanghai, China. Electronic address: aishanli0102@126.com.
3
Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No. 168 Changhai Road, Shanghai, China. Electronic address: tianbing2003@163.com.
4
Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No. 168 Changhai Road, Shanghai, China. Electronic address: liuqimd@126.com.
5
Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No. 168 Changhai Road, Shanghai, China. Electronic address: wangli_changhai@163.com.
6
Department of Radiology, Changhai Hospital of Shanghai, The Second Military Medical University, No. 168 Changhai Road, Shanghai, China. Electronic address: cjr.wangminjie@vip.163.com.

Abstract

PURPOSE:

This study aimed to evaluate the usefulness of four-dimensional CTA before and after embolization treatment with ONYX-18 in eleven patients with cranial dural arteriovenous fistulas, and to compare the results with those of the reference standard DSA.

PATIENTS AND METHODS:

Eleven patients with cranial dural arteriovenous fistulas detected on DSA underwent transarterial embolization with ONYX-18. Four-dimensional CTA was performed an average of 2 days before and 4 days after DSA. Four-dimensional CTA and DSA images were reviewed by two neuroradiologists for identification of feeding arteries and drainage veins and for determining treatment effects. Interobserver and intermodality agreement between four-dimensional CTA and DSA were assessed.

RESULTS:

Forty-two feeding arteries were identified for 14 fistulas in the 11 patients. Of these, 36 (85.71%) were detected on four-dimensional CTA. After transarterial embolization, one patient got partly embolized, and the fistulas in the remaining 10 patients were completely occluded. The interobserver agreement for four-dimensional CTA and intermodality agreement between four-dimensional CTA and DSA were excellent (κ=1) for shunt location, identification of drainage veins, and fistula occlusion after treatment.

CONCLUSION:

Four-dimensional CTA images are highly accurate when compared with DSA images both before and after transarterial embolization treatment. Four-dimensional CTA can be used for diagnosis as well as follow-up of cranial dural arteriovenous fistulas in clinical settings.

KEYWORDS:

DSA; Dural arteriovenous fistulas; Embolization; Four-dimensional CTA

PMID:
25818730
DOI:
10.1016/j.ejrad.2015.03.009
[Indexed for MEDLINE]

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