Differentiation of dural arteriovenous fistula from reflux venous flow on 3D TOF-MR angiography: identifying asymmetric enlargement of external carotid artery branches.
Clin Radiol
; 75(9): 714.e15-714.e20, 2020 09.
Article
in En
| MEDLINE
| ID: mdl-32591231
ABSTRACT
AIM:
To differentiate dural arteriovenous fistula (DAVF) from reflux venous flow (RVF) by assessment of asymmetric enlargement of external carotid artery (ECA) branches on three-dimensional (3D) time-of-flight magnetic resonance angiography (TOF-MRA). MATERIALS ANDMETHODS:
Nineteen patients with DAVF and 27 patients with RVF were included from September 2007 to April 2019. The locations of DAVF were the cavernous (n=9) and sigmoid-transverse (n=6) sinuses, and the jugular (n=3) and sphenoparietal (n=1) veins. Two radiologists visually assessed asymmetric enlargement of the ascending pharyngeal artery (ASP), middle meningeal artery (MMA), accessory meningeal artery (AMA), artery of the foramen rotundum, and occipital artery. MMA size was also measured quantitatively.RESULTS:
More frequent asymmetric enlargement of the ASP and MMA were seen in DAVF than in RVF (17 of 19 versus 3 of 27 for ASP; 16 of 19 versus 1 of 27 for MMA, p<0.01). The AMA, artery of the foramen rotundum, and occipital arteries were not visualised in RVF patients. The ipsilateral MMA size was significantly larger in DAVF than in RVF (2.14 versus 0.64 mm2, p< 0.01). The diagnostic performance of ipsilateral MMA size for DAVF was good, with an area under the receiver operating characteristic curve of 0.89, with a sensitivity of 84.2% and a specificity of 81.5% at a cut-off of 1.08 mm2.CONCLUSIONS:
DAVF showed significantly larger ECA branches than RVF on 3D TOF-MRA. Therefore, thorough evaluation of ECA branches could help to differentiate DAVF from RVF.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Regional Blood Flow
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Cerebral Angiography
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Carotid Artery, External
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Magnetic Resonance Angiography
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Central Nervous System Vascular Malformations
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Imaging, Three-Dimensional
Type of study:
Observational_studies
/
Prognostic_studies
Limits:
Aged
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Aged80
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Female
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Humans
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Male
/
Middle aged
Language:
En
Journal:
Clin Radiol
Year:
2020
Type:
Article