title: Evaluation of dural arteriovenous fistulas with 4D contrast-enhanced MR angiography at 3T.
abstract: OBJECTIVE
  Four-dimensional contrast-enhanced MR angiography (4D-CE-MRA) at 3T may replace digital subtraction angiography (DSA) for certain diagnostic purposes in patients with intracranial dural arteriovenous fistula (DAVF). The aim of this study was to test the hypothesis that 4D-CE-MRA at 3T enables the same characterization of intracranial DAVFs as DSA.
  
  
  METHODS
  The study population consisted of 18 consecutive patients with intracranial DAVFs (11 women, 7 men; age range, 35-82 years; mean age, 64.8 years). They underwent 4D-CE-MRA at 3T and DSA. The 4D-CE-MRA series combined randomly segmented central k-space ordering, keyhole imaging, sensitivity encoding, and half-Fourier imaging. We obtained 30 dynamic scans every 1.9 seconds with a spatial resolution of 1 x 1 x 1.5 mm. Two independent readers reviewed the 4D-CE-MRA images for main arterial feeders, fistula site, and venous drainage. Interobserver and intermodality agreement was assessed by kappa statistics.
  
  
  RESULTS
  At DSA, 8 fistulas were located at the transverse sigmoid sinus; 8, at the cavernous sinus; and 2, at the sinus adjacent to the foramen magnum. Interobserver agreement was fair for the main arterial feeders (kappa = 0.59), excellent for the fistula site (kappa = 0.91), and good for venous drainage (kappa = 0.86). Intermodality agreement was moderate for the main arterial feeders (kappa = 0.68) and excellent for the fistula site (kappa = 1.0) and venous drainage (kappa = 1.0).
  
  
  CONCLUSIONS
  The agreement between 4D-CE-MRA and DSA findings was good to excellent with respect to the fistula site and venous drainage.
authors.affiliation: Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Nishimura
authors.forename: T
authors.initials: T
authors.lastname: Hirai
authors.forename: A
authors.initials: A
authors.lastname: Sasao
authors.forename: M
authors.initials: M
authors.lastname: Kitajima
authors.forename: M
authors.initials: M
authors.lastname: Morioka
authors.forename: Y
authors.initials: Y
authors.lastname: Kai
authors.forename: Y
authors.initials: Y
authors.lastname: Omori
authors.forename: T
authors.initials: T
authors.lastname: Okuda
authors.forename: R
authors.initials: R
authors.lastname: Murakami
authors.forename: H
authors.initials: H
authors.lastname: Fukuoka
authors.forename: K
authors.initials: K
authors.lastname: Awai
authors.forename: J-I
authors.initials: JI
authors.lastname: Kuratsu
authors.forename: Y
authors.initials: Y
authors.lastname: Yamashita
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020785:Central Nervous System Vascular Malformations / Q000175:diagnosis*; D005260:Female; D006801:Humans; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies