title: Detection and grading of dAVF: prospects and limitations of 3T MRI.
abstract: OBJECTIVE
  DSA is currently the criterion standard for the assessment of dural arteriovenous fistulas (dAVF). Recently, evolving MRA techniques have emerged as a non-invasive alternative. The aim of this study is to assess the value of 3 T MRI in detecting and describing dAVF and to determine whether MRI can replace DSA as diagnostic procedure.
  
  
  METHODS
  A total of 19 patients with dAVF and 19 without dAVF underwent the same MRI protocol, including 3D time-of-flight MRA and time-resolved contrast-enhanced MRA. The images were evaluated retrospectively by three independent readers with different levels of experience blinded to clinical information. The readers assessed the presence, the site, the venous drainage and the feeders of dAVF. Sensitivity, specificity, accuracy, intertechnique and interobserver agreements were calculated.
  
  
  RESULTS
  DAVF can be detected with high sensitivity, specificity and accuracy by experienced and also by less experienced readers. However, MRI has limitations when used for grading and evaluation of the angioarchitecture of the dAVF. Different experience, the limited resolution of MRI and its inability to selectively display arteries were the reasons for these limitations.
  
  
  CONCLUSIONS
  With MRI dAVF can be detected reliably. Nevertheless, at present MRI can not fully replace DSA, especially for treatment planning.
authors.affiliation: Department of Neuroradiology, Johann Wolfgang Goethe University, Schleusenweg 2-16, Haus 95, D-60528, Frankfurt am Main, Germany. andrea.bink@kgu.de
authors.forename: Andrea
authors.initials: A
authors.lastname: Bink
authors.forename: Joachim
authors.initials: J
authors.lastname: Berkefeld
authors.forename: Marlies
authors.initials: M
authors.lastname: Wagner
authors.forename: Se-Jong
authors.initials: SJ
authors.lastname: You
authors.forename: Hanns
authors.initials: H
authors.lastname: Ackermann
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Lorenz
authors.forename: Christian
authors.initials: C
authors.lastname: Senft
authors.forename: Richard
authors.initials: R
authors.lastname: du Mesnil de Rochemont
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods; D020785:Central Nervous System Vascular Malformations / Q000473:pathology*; D003287:Contrast Media / Q000494:pharmacology; D003952:Diagnostic Imaging / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D010865:Pilot Projects; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors
chemical_list: D003287:Contrast Media