Dural arteriovenous fistula involving the transverse sigmoid sinus after treatment: assessment with magnetic resonance digital subtraction angiography.
BACKGROUND
The purpose of this study was to evaluate the utility of magnetic resonance digital subtraction angiography (MRDSA) in showing the presence or absence of retrograde venous drainage (RVD) in patients with intracranial dural arteriovenous fistula (DAVF) involving the transverse sigmoid sinus (TSS) after treatment.


METHODS
Of 16 patients with DAVF involving the TSS, 13 underwent digital subtraction angiography (DSA) and MRDSA before and after treatment, and 3 underwent DSA before treatment and DSA and MRDSA after treatment. Five patients underwent these procedures twice after treatment. A total of 21 examinations after treatment were evaluated retrospectively. The presence or absence of DAVF and RVD was decided on the basis of the DSA findings. Two neuroradiologists reviewed the MRDSA findings concerning the presence or absence of DAVF and RVD.


RESULTS
DSA showed residual DAVF in 9 and residual RVD in 5 of 21 examinations. MRDSA revealed residual DAVF in 8 of 21 examinations. MRDSA did not show residual DAVF in one examination because of a very small (low-flow) residual DAVF without RVD. MRDSA identified residual RVD in 5 of 21 examinations. MRDSA was completely consistent with DSA concerning the presence or absence of residual RVD.


CONCLUSIONS
MRDSA could evaluate the presence or absence of RVD in patients with DAVF involving TSS after treatment. MRDSA may give reliable information as to whether patients with DAVF involving the TSS should undergo additional DSA after treatment.
Noguchi
Kyo
K
Department of Radiology, Toyama University, 2630 Sugitani, Toyama 930-0194, Japan. kyo@med.u-toyama.ac.jp
Kuwayama
Naoya
N
Kubo
Michiya
M
Kamisaki
Yuichi
Y
Tomizawa
Gakuto
G
Kameda
Keisuke
K
Kawabe
Hideto
H
Ogawa
Shinichi
S
Kato
Hiroshi
H
Shimizu
Masashi
M
Watanabe
Naoto
N
Seto
Hikaru
H
D000368:Aged; D015901:Angiography, Digital Subtraction / Q000379:methods*; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D008875:Middle Aged