Evaluation of Intracranial Dural Arteriovenous Fistulas: Comparison of Unenhanced 3T 3D Time-of-flight MR Angiography with Digital Subtraction Angiography

Background Intracranial aneurysm with endovascular treatment needs to be followed-up with a proper imaging method. Purpose To evaluate the performance of magnetic resonance angiography (MRA) with zero echo time at 1.5-T in assessing the intracranial aneurysm remnant and in-stent lumen as compared with time-of-flight MRA, with digital subtraction angiography as the gold standard. Material and Methods A total of 46 patients (17 men; mean age = 56.6±13.7 years) with 54 aneurysms who underwent coil embolization with or without stent were enrolled in this study. The presence of aneurysm remnant and the visualization of in-stent lumen were evaluated. The agreement of remnant identification between MRA with zero echo time and time-of-flight MRA with digital subtraction angiography was evaluated using Cohen’s kappa analysis. The performance of in-stent lumen visualization between MRA with zero echo time and time-of-flight MR angiography was compared with Chi-square test. Results Of 54 aneurysms, 27 were found to have remnants by digital subtraction angiography. The kappa value in identification of remnant of aneurysm was 0.852 between MRA with zero echo time and digital subtraction angiography and 0.741 between time-of-flight MRA and digital subtraction angiography. In detecting remnant of aneurysm, the sensitivity, specificity, positive predictive value, and negative predictive value were 96.3%, 88.9%, 89.7%, and 96.0% for MRA with zero echo time and 91.7%, 83.3%, 81.5%, and 92.6% for time-of-flight MRA, respectively. In visualizing in-stent lumen, MRA with zero echo time had better performance than time-of-flight MRA ( P < 0.001). Conclusion MR angiography with zero echo time might be a better non-invasive approach in assessing remnant of aneurysms and in-stent lumen as compared with time-of-flight MRA.

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Accuracy and pitfalls of multidetector-row computed tomography in detecting spinal dural arteriovenous fistulas

Journal of Neurosurgery Spine ◽

10.3171/2009.9.spine0971 ◽

2010 ◽

Vol 12 (3) ◽

pp. 243-248 ◽

Cited By ~ 21

Author(s):

Satoshi Yamaguchi ◽

Tetsuya Nagayama ◽

Kuniki Eguchi ◽

Masaaki Takeda ◽

Kazunori Arita ◽

...

Keyword(s):

Digital Subtraction Angiography ◽

Nerve Root ◽

Multidetector Row Computed Tomography ◽

Digital Subtraction ◽

Selective Angiography ◽

Multidetector Row ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Spinal Dural Arteriovenous Fistulas ◽

Spinal Epidural

Object The purpose of this study was to evaluate the accuracy of multidetector-row CT angiography (MDCTA) in demonstrating spinal dural arteriovenous fistulas (SDAVFs). Methods The authors studied 10 patients with SDAVFs, including 2 with spinal epidural AVFs, who underwent preoperative MR imaging, MDCTA, and digital subtraction angiography (DSA). In the evaluation of coronal sections of multiplanar reformation MDCTA images, inspection was focused on the presence of the following findings: 1) dilated perimedullary veins in the spinal canal; 2) focal enhancement of the nerve root, suggesting the location of the AVF, around the dural sleeve; and 3) a radicular vein that drains the AVF into perimedullary veins. The utility of MDCTA was assessed by comparing its findings with those of DSA in each case. Results Digital subtraction angiography confirmed that the AVFs were located in the thoracic spine in 4 patients and in the lumbar spine in 6 patients, and MDCTA detected dilated perimedullary veins in all 10 patients. In 8 patients, there was focal enhancement of the nerve root. The radicular vein that drains the AVF into the perimedullary veins was found in 8 cases. In 8 cases, the MDCTA-derived level and side of the AVF and its feeder corresponded with those shown by DSA. In 2 patients, however, the MDCTA-derived side of the feeder was on the side contralateral to the feeding artery confirmed by DSA. These lesions were interpreted as spinal epidural AVFs with perimedullary drainage. In 2 cases, MDCTA could not detect the multiplicity of their feeders. Conclusions The use of MDCTA preceding DSA can be helpful to focus the selective catheter angiography on certain spinal levels. However, one should keep in mind that epidural AVFs with perimedullary drainage may resemble SDAVFs and also that MDCTA cannot exclude the possibility of multiple feeders. Further research should elucidate how broadly selective angiography should explore around the MDCTA-suggested target.

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Multidirectional Depiction of Internal Carotid Arterial Stenosis: Three-dimensional Time-of-Flight MR Angiography versus Rotational and Conventional Digital Subtraction Angiography

Radiology ◽

10.1148/radiology.216.2.r00au02511 ◽

2000 ◽

Vol 216 (2) ◽

pp. 511-516 ◽

Cited By ~ 51

Author(s):

Otto E. H. Elgersma ◽

Aloys F. J. Wüst ◽

Pieter C. Buijs ◽

Yolanda van der Graaf ◽

Bert C. Eikelboom ◽

...

Keyword(s):

Digital Subtraction Angiography ◽

Mr Angiography ◽

Internal Carotid ◽

Three Dimensional ◽

Time Of Flight ◽

Arterial Stenosis ◽

Digital Subtraction ◽

Carotid Arterial

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Feasibility of low-dose digital subtraction angiography protocols for the endovascular treatment of intracranial dural arteriovenous fistulas

Neuroradiology ◽

10.1007/s00234-020-02537-2 ◽

2020 ◽

Author(s):

Yunsun Song ◽

Seongsik Han ◽

Byung Jun Kim ◽

Seong Heum Oh ◽

Jin Su Kim ◽

...

Keyword(s):

Endovascular Treatment ◽

Digital Subtraction Angiography ◽

Low Dose ◽

Digital Subtraction ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

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Characteristics and long-term outcome of 251 patients with dural arteriovenous fistulas in a defined population

Journal of Neurosurgery ◽

10.3171/2012.11.jns111604 ◽

2013 ◽

Vol 118 (5) ◽

pp. 923-934 ◽

Cited By ~ 44

Author(s):

Anna Piippo ◽

Mika Niemelä ◽

Jouke van Popta ◽

Marko Kangasniemi ◽

Jaakko Rinne ◽

...

Keyword(s):

Digital Subtraction Angiography ◽

Stereotactic Radiosurgery ◽

Detection Rate ◽

Treatment Modalities ◽

Digital Subtraction ◽

Term Outcome ◽

Long Term Outcome ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

Object Management of dural arteriovenous fistulas (DAVFs) has changed during the last decades due to increased knowledge of their pathophysiology and natural history as well as advances in treatment modalities. The authors describe the characteristics and long-term outcome of a large consecutive series of patients with DAVFs. Methods Altogether 251 patients with 261 DAVFs were treated in 2 of the 5 neurosurgery departments at Helsinki and Kuopio University Hospitals between 1944 and 2006. Clinical data and radiological examinations were reviewed to assess patients' overall long-term clinical outcome. Results The detection rate of DAVFs increased markedly in the 1970s and again in the 1990s when digital subtraction angiography was introduced. The incidence of DAVFs in a defined southern Finnish population was 0.51 per 100,000 individuals per year, which represents 32% of all the brain arteriovenous malformations. In the early part of the series, DAVFs were treated by proximal ligation of the feeding arteries. Later, most of the patients underwent preoperative embolization and subsequent craniotomy, and since 2000 stereotactic radiosurgery has been increasingly used in the treatment of DAVFs. Fifty-nine percent of the 261 fistulas were totally occluded. Treatment-related major complications were seen in 21 patients. Conclusions The advances in diagnostic methods (digital subtraction angiography, CT, and MRI) increased the detection rate of DAVFs, and as treatment modalities developed, the results of treatment and outcome of patients markedly improved with the introduction of endovascular techniques and stereotactic radiosurgery. Microsurgery is of limited use in DAVFs resistant to other treatment modalities.

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