title: 4D-CT angiography differentiating arteriovenous fistula subtypes.
abstract: OBJECTIVE
  In the diagnostic work-up of patients suspected of a dural arteriovenous fistula (dAVF), imaging has a key role in order to diagnose the dAVF, assess its bleeding risk and choose optimal treatment strategy. Digital subtraction angiography (DSA) is the gold standard for the most detailed image of a dAVF. Nowadays four-dimensional CT angiography (4D-CTA) could possibly be an additional first-line tool in the work-up of a patient suspected of a dAVF. We describe three cases clinically suspected of a dAVF which had a diagnostic work-up with 4D-CTA as well as DSA. We evaluated the angioarchitecture of the dAVF both on 4D-CTA and DSA, with emphasis on the patterns of venous drainage as this is important in assessing the bleeding risk of a dAVF.
  
  
  CONCLUSIONS
  4D-CTA identified the dAVF, revealed its angioarchitecture and correctly differentiated different patterns of venous drainage (Borden type I, II and III) as confirmed on DSA. Although DSA has the advantage of higher spatial and temporal resolution, 4D-CTA seems to be a new useful non-invasive tool in the diagnostic work-up of a patient suspected of a dAVF.
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands.
authors.forename: Tim R
authors.initials: TR
authors.lastname: Beijer
authors.forename: Ewoud J
authors.initials: EJ
authors.lastname: van Dijk
authors.forename: Joost
authors.initials: J
authors.lastname: de Vries
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Vermeer
authors.forename: Mathias
authors.initials: M
authors.lastname: Prokop
authors.forename: Frederick J A
authors.initials: FJ
authors.lastname: Meijer
mesh_terms: D000647:Amnesia / Q000209:etiology; D015901:Angiography, Digital Subtraction / Q000379:methods; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods*; D002550:Cerebral Veins / Q000000981:diagnostic imaging; D003221:Confusion / Q000209:etiology; D004828:Epilepsies, Partial / Q000209:etiology; D004830:Epilepsy, Tonic-Clonic / Q000209:etiology; D005260:Female; D006429:Hemiplegia / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D010292:Paresthesia / Q000209:etiology; D012640:Seizures / Q000209:etiology / Q000503:physiopathology; D014057:Tomography, X-Ray Computed / Q000379:methods*
keywords: 4D CTA; Brain; Dural arteriovenous fistula; Neuroimaging; Neurovascular