title: Fusion imaging using subtracted and unsubtracted rotational angiography for pretherapeutic evaluation of dural arteriovenous fistulas.
abstract: OBJECTIVE
  We describe the clinical utility of an imaging technique that combines 3D subtracted and unsubtracted rotational angiography for evaluation of the angioarchitecture of dural arteriovenous fistulas (DAVFs).
  
  
  METHODS
  From May 2010 to June 2013, 21 consecutive patients with intracranial DAVFs (22 lesions) underwent 3D angiography for pretherapeutic evaluation. 3D fusion angiography (3DFA) images were semiautomatically obtained from a dataset of unsubtracted and subtracted rotational angiographs. Multiplanar reformatted images and partial MIP images from unsubtracted rotational angiography and fusion images were evaluated by two radiologists, with particular focus on visualization of feeding arteries, shunted pouches, and drainage veins of DAVFs by use of a 3-point scale. The referring neuroradiologists were asked whether the information provided by 3DFA was helpful for treatment decisions.
  
  
  RESULTS
  For 21 of 22 lesions, all evaluated items were well depicted on the 3DFA. The visualization rating score for feeding arteries and shunted pouches on 3DFA were significantly higher than those of 3D digital angiography (p < 0.05). There were no statistically significant differences between visualization of drainage veins. The information provided by the fusion images was helpful for treatment decisions in all cases.
  
  
  CONCLUSIONS
  3DFA images are useful for evaluation of the angioarchitecture of intracranial DAVFs.
authors.affiliation: Department of Radiology, Oita University Faculty of Medicine, 1-1 Idaigaoka, Hasama, Yufu, Oita, 879-5963, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Tanoue
authors.forename: Hiro
authors.initials: H
authors.lastname: Kiyosue
authors.forename: Hiromu
authors.initials: H
authors.lastname: Mori
authors.forename: Norio
authors.initials: N
authors.lastname: Hongo
authors.forename: Mika
authors.initials: M
authors.lastname: Okahara
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kubo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction / Q000379:methods*; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D012189:Retrospective Studies