Advanced

AJNR - American Journal of Neuroradiology

Published ahead of print on June 26, 2008
doi: 10.3174/ajnr.A1187

This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: ajnr.A1187v1 29/9/1652    most recent Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Akiba, H. Articles by Hareyama, M. Search for Related Content PubMed PubMed Citation Articles by Akiba, H. Articles by Hareyama, M.

American Journal of Neuroradiology 29:1652-1657, October 2008
© 2008 American Society of Neuroradiology

BRAIN

Assessment of Dural Arteriovenous Fistulas of the Cavernous Sinuses on 3D Dynamic MR Angiography

H. Akiba^a, M. Tamakawa^a, H. Hyodoh^a, K. Hyodoh^a, N. Yama^a, T. Nonaka^b, Y. Minamida^b, M. Hashimoto^c and M. Hareyama^a

^a Department of Radiology, Sapporo Medical University, School of Medicine, Sapporo, Japan
^b Department of Neurosurgery, Sapporo Medical University, School of Medicine, Sapporo, Japan
^c Department of Ophthalmology, Sapporo Medical University, School of Medicine, Sapporo, Japan

Please address correspondence to Hidenari Akiba. MD, PhD, Department of Radiology, Sapporo Medical University, School of Medicine, W-16, S-1, Chuo-ku, Sapporo, 060-0061, Japan; e-mail akibah{at}sapmed.ac.jp

BACKGROUND AND PURPOSE: Flow voids within the cavernous sinuses and/or certain venous drainage on spin-echo MR imaging and time-of-flight (TOF) flow enhancement on MR angiography (MRA) have indicated high-velocity shunt flow and have been used for screening patients with dural arteriovenous fistulas (DAVFs) of the cavernous sinuses. In this investigation, the capabilities of 3D dynamic MRA as a flow-independent approach and those of conventional MR imaging techniques were compared with selective angiography for the diagnosis of DAVFs of the cavernous sinuses.

MATERIALS AND METHODS: This retrospective study involved 18 patients with angiographically proved DAVFs of the cavernous sinuses and 12 control subjects. Sixteen partially overlapping sequential MR images were acquired on contrast-enhanced 3D dynamic MRA between the petrosal bone and the orbital roof. Two experienced observers blinded to the clinical data and results of angiography independently graded 3D dynamic MRA, fast spin-echo T2-weighted imaging (FSE T2WI), and TOF MRA.

RESULTS: The average area under the receiver operating characteristic curve values and interobserver scores for the diagnosis of DAVFs on 3D dynamic MRA, FSE T2WI, and TOF MRA were 0.99, 0.89, and 0.95; and 0.92, 0.71, and 0.73, respectively. Those for the diagnosis of anterior, posterior, and retrograde cortical venous drainage on 3D dynamic MRA were 0.72, 0.95, and 0.81; and 0.56, 0.50, and 0.49, respectively.

CONCLUSION: In this small series, screening 3D dynamic MRA directly demonstrates DAVFs of the cavernous sinuses and has improved diagnostic capability.

This article has been cited by other articles:

				R.I. Farb, R. Agid, R.A. Willinsky, D.M. Johnstone, and K.G. terBrugge Cranial Dural Arteriovenous Fistula: Diagnosis and Classification with Time-Resolved MR Angiography at 3T AJNR Am. J. Neuroradiol., September 1, 2009; 30(8): 1546 - 1551. [Abstract] [Full Text] [PDF]