RT Journal Article
SR Electronic
T1 3D C-Arm Conebeam CT Angiography as an Adjunct in the Precise Anatomic Characterization of Spinal Dural Arteriovenous Fistulas
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 476
OP 480
DO 10.3174/ajnr.A1840
VO 31
IS 3
A1 T.D. Aadland
A1 K.R. Thielen
A1 T.J. Kaufmann
A1 J.M. Morris
A1 G. Lanzino
A1 D.F. Kallmes
A1 B.A. Schueler
A1 H. Cloft
YR 2010
UL http://www.ajnr.org/content/31/3/476.abstract
AB BACKGROUND AND PURPOSE: Precise anatomic understanding of the vascular anatomy of SDAVFs is required before treatment. This study demonstrates the utility of C-arm conebeam CT to locate precisely the fistulous point in SDAVFs and the courses of their feeding arteries and draining veins. MATERIALS AND METHODS: This retrospective study reports 14 consecutive patients with SDAVFs who underwent DSA and C-arm conebeam CT angiography. SDAVF sites included 5 thoracic, 7 lumbar, and 2 sacral fistulas. Selective DSA initially identified the location and arterial supply of the SDAVF. C-arm conebeam CT angiography was then performed with selective injection into the feeding artery. Reconstructed images were reviewed at a workstation with the referring surgeon, in conjunction with the standard 2D DSA images. The value of C-arm conebeam CT in depicting the fistula and the relationship to adjacent structures was qualitatively assessed. RESULTS: In all 14 patients, C-arm conebeam CT angiography was technically successful and precisely demonstrated the site of the fistula, feeding arteries, draining veins, and the relationship of the fistula to adjacent osseous structures. Information obtained from the C-arm conebeam CT angiogram was considered useful in all surgically (12 patients) and endovascularly (2 patients) treated SDAVFs. CONCLUSIONS: 3D C-arm conebeam CT angiography is a useful adjunct to 2D DSA in the anatomic characterization of SDAVFs. The technique allowed improved visualization of the vascular anatomy of the SDAVFs and clearer definition of their spatial relationships to adjacent structures. APanteroposteriorAVarteriovenousDSAdigital subtraction angiographyMPRmultiplanar reformationSDAVFspinal dural arteriovenous fistula