Document Detail


Intracranial dural arteriovenous fistulas: diagnosis and evaluation with 64-detector row CT angiography.
MedLine Citation:
PMID:  20574098     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To analyze the diagnostic effectiveness and application of computed tomographic (CT) angiography by using a new algorithm (hybrid CT angiography) in dural arteriovenous fistulas (AVFs). MATERIALS AND METHODS: Institutional review board approval was obtained for retrospectively postprocessing the raw data from CT angiography by using hybrid CT, which is a mixture of a bone subtraction and masking method for bone removal. The study included 22 patients with 24 dural AVFs and 14 control subjects. The grades in patients with dural AVF determined with hybrid CT angiography and digital subtraction angiography (DSA) were compared, and hybrid CT angiography was applied as a tool for planning endovascular treatment. The adjusted Wald method was used to estimate confidence intervals (CIs), and the Cohen kappa statistic was used to assess interobserver agreement. RESULTS: Hybrid CT angiography in the 24 dural AVFs revealed asymmetric sinus enhancement in 22 lesions (92%), engorged arteries in 19 (79%), transosseous enhanced vessels in 19 (79%), engorged extracranial veins in 13 (54%), engorged cortical veins in seven (29%), and sinus thrombosis in four (17%). In all 24 lesions, at least two of six imaging signs for diagnosis of dural AVFs were present. The kappa test analysis revealed a high level of interobserver agreement (kappa, 0.56-1.00) in reading the diagnostic imaging signs. The observed agreement between DSA and readers was 100% in the cavernous sinus region and in hypoglossal and clival lesions and 78%-89% in the transverse sigmoid sinus. The overall sensitivity, specificity, positive predictive value, and negative predictive value were 0.93 (95% CI: 0.85, 0.97), 0.98 (95% CI: 0.93, 1.00), 0.97 (95% CI: 0.90, 0.99), and 0.95 (95% CI: 0.90, 0.98), respectively. CONCLUSION: Hybrid CT angiography is a promising tool for the diagnosis of dural AVF. It can provide key information necessary for treatment planning.
Authors:
Chung-Wei Lee; Adam Huang; Yao-Hung Wang; Chung-Yi Yang; Ya-Fang Chen; Hon-Man Liu
Related Documents :
18511868 - Vessel wall contrast enhancement: a diagnostic sign of cerebral vasculitis.
498908 - Risk-decreasing factors in the angiographic examination of intracranial haemorrhage.
21731998 - Recurrent vertebral hydatid disease: spectrum of mr imaging features.
20569618 - Morphological change of unruptured vertebral artery dissection on serial mr examination...
11510458 - Kinematic mr imaging of the knee.
16423668 - Effects of ultrasound contrast during tissue velocity imaging on regional left ventricu...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Radiology     Volume:  256     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2010 Jul 
Date Detail:
Created Date:  2010-06-24     Completed Date:  2010-07-16     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  219-28     Citation Subset:  AIM; IM    
Affiliation:
Department of Medical Imaging and Radiology, Hospital and Medical College, National Taiwan University, Taipei, Taiwan, Republic of China.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Algorithms
Angiography, Digital Subtraction
Central Nervous System Vascular Malformations / radiography*,  therapy
Cerebral Angiography / methods*
Contrast Media / diagnostic use
Female
Humans
Iohexol / analogs & derivatives,  diagnostic use
Male
Middle Aged
Patient Care Planning
Predictive Value of Tests
Radiographic Image Interpretation, Computer-Assisted
Retrospective Studies
Sensitivity and Specificity
Tomography, X-Ray Computed / methods*
Chemical
Reg. No./Substance:
0/Contrast Media; 66108-95-0/Iohexol; 73334-07-3/iopromide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Symptomatic Carotid Artery Stenosis: Impairment of Cerebral Autoregulation Measured at the Brain Tis...
Next Document:  Diffuse Lung Disease: CT of the Chest with Adaptive Statistical Iterative Reconstruction Technique.