PT  - JOURNAL ARTICLE
AU  - Clayton Chi-Chang Chen
AU  - Patricia Chuen-Tsuei Chang
AU  - Cherng-Gueih Shy
AU  - Wen-Shien Chen
AU  - Hao-Chun Hung
TI  - CT Angiography and MR Angiography in the Evaluation of Carotid Cavernous Sinus Fistula Prior to Embolization: A Comparison of Techniques
DP  - 2005 Oct 01
TA  - American Journal of Neuroradiology
PG  - 2349--2356
VI  - 26
IP  - 9
4099  - http://www.ajnr.org/content/26/9/2349.short
4100  - http://www.ajnr.org/content/26/9/2349.full
SO  - Am. J. Neuroradiol.2005 Oct 01; 26
AB  - BACKGROUND AND PURPOSE: This study compared CT angiography (CTA), MR angiography (MRA), and digital subtraction angiography (DSA) in elucidating the size and location of carotid cavernous sinus fistulas (CCFs) before embolization treatment.METHODS: This was a retrospective study of 53 patients with angiographically confirmed CCF. All patients underwent pre- and postcontrast-enhanced CTA and DSA, and 50 patients also underwent MRA. Two neuroradiologists rated detectability of the fistula tract as “good,” “moderate,” or “poor” in source images obtained by using each procedure. The χ2 test was used to compare the imaging modalities with respect to their ability to detect fistulas.RESULTS: CTA did not differ significantly from DSA (P = .155), and both CTA (P = .001) and DSA (P = .007) performed significantly better than MRA in the population as a whole. Differences in performance among the methods, however, depended upon the segmental location of the fistula along the internal carotid artery (ICA). CTA and MRA were similar in detection of CCFs in patients with a fistula at segment 3. CTA significantly outperformed MRA in patients with a fistula at segment 4, who accounted for approximately half of the population.CONCLUSIONS: CTA source imaging has proved itself as useful as DSA for detecting CCFs. Of the 2 noninvasive techniques, CTA performed better than MRA in the population as a whole and in most patients whose fistula was located at segment 4 or 5 of the ICA.