title: Accuracy of four-dimensional CT angiography in detection and characterisation of arteriovenous malformations and dural arteriovenous fistulas.
abstract: A retrospective review was made to assess the accuracy of four dimensional CT angiogram (4D-CTA) in diagnosis of arteriovenous malformations (AVM) and dural arteriovenous fistulas (DAVF), with catheter-based digital-subtraction angiogram (DSA) being gold standard. 33 pairs of investigations (DSA and 4D-CTA) were performed primarily for suspicion of AVM/DAVF. Based on blinded reports, sensitivity and specificity for detection of AVM/DAVF were 77% (95% CI: 46-95%) and 100% (95% CI: 83-100%) respectively. Positive predictive value was 100% (95% CI: 69-100%) and negative predictive value 87% (95% CI: 66-97%). 4D-CTA is a practical minimally-invasive technique for evaluating cerebrovascular pathologies. There is good agreement between the findings of 4D-CTA and DSA despite the differences in temporal and spatial resolutions. 4D-CTA may obviate the need for DSA in a subgroup of patients who would otherwise have undergone this invasive investigation, which carries a risk of important complications.
authors.affiliation: Department of Neuroradiology, The Walton Centre for Neurology and Neurosurgery, UK Shubhabrata.Biswas@thewaltoncentre.nhs.uk.
authors.forename: Shubhabrata
authors.initials: S
authors.lastname: Biswas
authors.affiliation: Department of Neuroradiology, The Walton Centre for Neurology and Neurosurgery, UK.
authors.forename: Arun
authors.initials: A
authors.lastname: Chandran
authors.affiliation: Department of Neuroradiology, The Walton Centre for Neurology and Neurosurgery, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Radon
authors.affiliation: Department of Neuroradiology, The Walton Centre for Neurology and Neurosurgery, UK.
authors.forename: Mani
authors.initials: M
authors.lastname: Puthuran
authors.affiliation: Department of Neuroradiology, The Walton Centre for Neurology and Neurosurgery, UK.
authors.forename: Maneesh
authors.initials: M
authors.lastname: Bhojak
authors.affiliation: Department of Neuroradiology, The Walton Centre for Neurology and Neurosurgery, UK.
authors.forename: Hans Christean
authors.initials: HC
authors.lastname: Nahser
authors.affiliation: Department of Neuroradiology, The Walton Centre for Neurology and Neurosurgery, UK.
authors.forename: Kumar
authors.initials: K
authors.lastname: Das
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015901:Angiography, Digital Subtraction; D020785:Central Nervous System Vascular Malformations / Q000000981:diagnostic imaging*; D002533:Cerebral Angiography / Q000379:methods*; D003287:Contrast Media; D005260:Female; D056973:Four-Dimensional Computed Tomography / Q000379:methods*; D006801:Humans; D002538:Intracranial Arteriovenous Malformations / Q000000981:diagnostic imaging*; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide
keywords: Four-dimensional CT angiogram; arteriovenous malformation; digital subtraction angiography; dural arteriovenous fistula