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Detection and grading of dAVF: prospects and limitations of 3T MRI

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Abstract

Objectives

DSA is currently the criterion standard for the assessment of dural arteriovenous fistulas (dAVF). Recently, evolving MRA techniques have emerged as a non-invasive alternative. The aim of this study is to assess the value of 3 T MRI in detecting and describing dAVF and to determine whether MRI can replace DSA as diagnostic procedure.

Methods

A total of 19 patients with dAVF and 19 without dAVF underwent the same MRI protocol, including 3D time-of-flight MRA and time-resolved contrast-enhanced MRA. The images were evaluated retrospectively by three independent readers with different levels of experience blinded to clinical information. The readers assessed the presence, the site, the venous drainage and the feeders of dAVF. Sensitivity, specificity, accuracy, intertechnique and interobserver agreements were calculated.

Results

DAVF can be detected with high sensitivity, specificity and accuracy by experienced and also by less experienced readers. However, MRI has limitations when used for grading and evaluation of the angioarchitecture of the dAVF. Different experience, the limited resolution of MRI and its inability to selectively display arteries were the reasons for these limitations.

Conclusions

With MRI dAVF can be detected reliably. Nevertheless, at present MRI can not fully replace DSA, especially for treatment planning.

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Acknowledgement

The authors thank Marina Heibel, Stefanie Pellikan and Lars Göttig for their technical support.

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Authors and Affiliations

  1. Department of Neuroradiology, Johann Wolfgang Goethe University, Schleusenweg 2-16, Haus 95, D-60528, Frankfurt am Main, Germany

    Andrea Bink, Joachim Berkefeld, Marlies Wagner, Se-Jong You & Richard du Mesnil de Rochemont

  2. Institute of Biostatistics and Mathematical Modeling, Johann Wolfgang Goethe University, Frankfurt/Main, Germany

    Hanns Ackermann

  3. Department of Neurology, Johann Wolfgang Goethe University, Frankfurt/Main, Germany

    Matthias W. Lorenz

  4. Department of Neurosurgery, Johann Wolfgang Goethe University, Frankfurt/Main, Germany

    Christian Senft

Authors
  1. Andrea Bink
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  2. Joachim Berkefeld
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  3. Marlies Wagner
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  4. Se-Jong You
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  5. Hanns Ackermann
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  6. Matthias W. Lorenz
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  7. Christian Senft
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  8. Richard du Mesnil de Rochemont
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Correspondence to Andrea Bink.

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Bink, A., Berkefeld, J., Wagner, M. et al. Detection and grading of dAVF: prospects and limitations of 3T MRI. Eur Radiol 22, 429–438 (2012). https://doi.org/10.1007/s00330-011-2268-2

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  • DOI: https://doi.org/10.1007/s00330-011-2268-2

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