title: CT and MR imaging of non-cavernous cranial dural arteriovenous fistulas: Findings associated with cortical venous reflux.
abstract: OBJECTIVE
  To compare the conventional CT and MR findings of DAVFs in relation to the venous drainage pattern on digital subtraction angiography (DSA).
  
  
  METHODS
  Cross-sectional imaging findings (CT and/or MR) in 92 patients were compared to the presence of cortical venous reflux (CVR) on DSA.
  
  
  RESULTS
  Imaging features significantly more prevalent in patients with CVR included: abnormally dilated and tortuous leptomeningeal vessels (92% vs. 4%, p<0.001) or medullary vessels (69% vs. 0%, p<0.001), venous ectasias (45% vs. 0%, p<0.001) and focal vasogenic edema (38% vs. 0%, p<0.001). The following findings trended towards association but did not reach the p value established following Bonferroni correction: dilated external carotid artery branches (71% vs. 38%, p=0.005), cluster of vessels surrounding dural venous sinus (50% vs. 19%, p=0.009), presence of hemorrhage (33 vs. 12%, p=0.040), and parenchymal enhancement (21% vs. 0%, p=0.030).
  
  
  CONCLUSIONS
  In the appropriate clinical setting, recognition of ancillary signs presumably related to venous arterialization and congestion as well as arterial feeder hypertrophy should prompt DSA confirmation to identify DAVFs associated with CVR.
authors.affiliation: Toronto Western Hospital-University Health Network and the University of Toronto, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario, Canada.
authors.forename: Laurent
authors.initials: L
authors.lastname: Letourneau-Guillon
authors.affiliation: Toronto Western Hospital-University Health Network and the University of Toronto, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario, Canada.
authors.forename: Juan Pablo
authors.initials: JP
authors.lastname: Cruz
authors.affiliation: Toronto Western Hospital-University Health Network and the University of Toronto, Division of Neuroradiology, Department of Medical Imaging, Toronto, Ontario, Canada. Electronic address: Timo.Krings@uhn.ca.
authors.forename: Timo
authors.initials: T
authors.lastname: Krings
mesh_terms: D000368:Aged; D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging* / Q000473:pathology*; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011856:Radiographic Image Enhancement; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media
keywords: Arteriovenous fistula; Central nervous system diseases; Intracranial arteriovenous malformations; Intracranial hemorrhages; Magnetic resonance imaging; Multidetectorcomputed tomography