4D-CT angiography differentiating arteriovenous fistula subtypes |
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| Authors: | Tim R. Beijer Ewoud J. van Dijk Joost de Vries Sarah E. Vermeer Mathias Prokop Frederick J.A. Meijer |
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| Affiliation: | 1. Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;2. Department of Neurosurgery, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands;3. Department of Neurology, Rijnstate Medical Centre, Arnhem, The Netherlands;4. Department of Radiology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands |
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| Abstract: | Objective and methodsIn the diagnostic work-up of patients suspected of a dural arteriovenous fistula (dAVF), imaging has a key role in order to diagnose the dAVF, assess its bleeding risk and choose optimal treatment strategy. Digital subtraction angiography (DSA) is the gold standard for the most detailed image of a dAVF. Nowadays four-dimensional CT angiography (4D-CTA) could possibly be an additional first-line tool in the work-up of a patient suspected of a dAVF. We describe three cases clinically suspected of a dAVF which had a diagnostic work-up with 4D-CTA as well as DSA. We evaluated the angioarchitecture of the dAVF both on 4D-CTA and DSA, with emphasis on the patterns of venous drainage as this is important in assessing the bleeding risk of a dAVF.Results and conclusion4D-CTA identified the dAVF, revealed its angioarchitecture and correctly differentiated different patterns of venous drainage (Borden type I, II and III) as confirmed on DSA. Although DSA has the advantage of higher spatial and temporal resolution, 4D-CTA seems to be a new useful non-invasive tool in the diagnostic work-up of a patient suspected of a dAVF. |
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| Keywords: | Dural arteriovenous fistula 4D CTA Brain Neurovascular Neuroimaging |
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