title: Cerebral vascular malformations: Time-resolved CT angiography compared to DSA.
abstract: OBJECTIVE
  The purpose of this article is to prospectively test the hypothesis that time-resolved CT angiography (TRCTA) on a Toshiba 320-slice CT scanner enables the same characterization of cerebral vascular malformation (CVM) including arteriovenous malformation (AVM), dural arteriovenous fistula (DAVF), pial arteriovenous fistula (PAVF) and developmental venous anomaly (DVA) compared to digital subtraction angiography (DSA).
  
  
  METHODS
  Eighteen (eight males, 10 females) consecutive patients (11 AVM, four DAVF, one PAVF, and two DVA) underwent 19 TRCTA (Aquillion one, Toshiba) for suspected CVM diagnosed on routine CT or MRI. One patient with a dural AVF underwent TRCTA and DSA twice before and after treatment. Of the 18 patients, 13 were followed with DSA (Artis, Siemens) within two months of TRCTA. Twenty-three sequential volume acquisitions of the whole head were acquired after injection of 50 ml contrast at the rate of 4 ml/sec. Two patients with DVA did not undergo DSA. Two TRCTA were not assessed because of technical problems.TRCTAs were independently reviewed by two neuroradiologists and DSA by two other neuroradiologists and graded according to the Spetzler-Martin classification, Borden classification, overall diagnostic quality, and level of confidence. Weighted kappa coefficients (k) were calculated to compare reader's assessment of DSA vs TRCTA.
  
  
  RESULTS
  There was excellent (k = 0.83 and 1) to good (k = 0.56, 0.61, 0.65 and 0.67) agreement between the different possible pairs of neuroradiologists for the assessment of vascular malformations.
  
  
  CONCLUSIONS
  TRCTA may be a sufficient noninvasive substitute for conventional DSA in certain clinical situations.
authors.affiliation: Department of Radiology, Division of Neuroradiology, Dalhousie University, Canada shivajai1@rediffmail.com shivajai1@gmail.com.
authors.forename: Jai Jai Shiva
authors.initials: JJ
authors.lastname: Shankar
authors.affiliation: Department of Diagnostic Imaging, The Ottawa Hospital, Canada.
authors.forename: Cheemun
authors.initials: C
authors.lastname: Lum
authors.affiliation: Department of Diagnostic Imaging, The Ottawa Hospital, Canada.
authors.forename: Santanu
authors.initials: S
authors.lastname: Chakraborty
authors.affiliation: Department of Diagnostic Imaging, The Ottawa Hospital, Canada.
authors.forename: Marlise
authors.initials: M
authors.lastname: Dos Santos
mesh_terms: D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging; D008297:Male; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
keywords: arterio-venous fistula; arterio-venous malformation; digital subtraction angiogram; time resolved CT angiogram