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<meta name="DC.Title" content="Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts" />
<meta name="DC.Identifier" content="10.3174/ajnr.A6156" />
<meta name="DC.Date" content="2019-09-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: 4D CT angiography is increasingly used in clinical practice for the assessment of different neurovascular disorders. Optimized processing of 4D-CTA is crucial for diagnostic interpretation because of the large amount of data that is generated. A color-mapping method for 4D-CTA is presented for improved and enhanced visualization of the cerebral vasculature hemodynamics. This method was applied to detect cranial AVFs.

MATERIALS AND METHODS: All patients who underwent both 4D-CTA and DSA in our hospital from 2011 to 2018 for the clinical suspicion of a cranial AVF or carotid cavernous fistula were retrospectively collected. Temporal information in the cerebral vasculature was visualized using a patient-specific color scale. All color-maps were evaluated by 3 observers for the presence or absence of an AVF or carotid cavernous fistula. The presence or absence of cortical venous reflux was evaluated as a secondary outcome measure.

RESULTS: In total, 31 patients were included, 21 patients with and 10 without an AVF. Arterialization of venous structures in AVFs was accurately visualized using color-mapping. There was high sensitivity (86%–100%) and moderate-to-high specificity (70%–100%) for the detection of AVFs on color-mapping 4D-CTA, even without the availability of dynamic subtraction rendering. The diagnostic performance of the 3 observers in the detection of cortical venous reflux was variable (sensitivity, 43%–88%; specificity, 60%–80%).

CONCLUSIONS: Arterialization of venous structures can be visualized using color-mapping of 4D-CTA and proves to be accurate for the detection of cranial AVFs. This finding makes color-mapping a promising visualization technique for assessing temporal hemodynamics in 4D-CTA.

CCF
:   carotid cavernous fistula
TTS
:   time-to-signal" />
<meta name="DC.Contributor" content="M. Meijs" />
<meta name="DC.Contributor" content="S.A.H. Pegge" />
<meta name="DC.Contributor" content="K. Murayama" />
<meta name="DC.Contributor" content="H.D. Boogaarts" />
<meta name="DC.Contributor" content="M. Prokop" />
<meta name="DC.Contributor" content="P.W.A. Willems" />
<meta name="DC.Contributor" content="R. Manniesing" />
<meta name="DC.Contributor" content="F.J.A. Meijer" />
<meta name="article:published_time" content="2019-09-01" />
<meta name="article:section" content="Adult Brain" />
<meta name="citation_title" content="Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts" />
<meta name="citation_abstract" lang="en" content="&lt;h3&gt;BACKGROUND AND PURPOSE:&lt;/h3&gt;
&lt;p&gt;4D CT angiography is increasingly used in clinical practice for the assessment of different neurovascular disorders. Optimized processing of 4D-CTA is crucial for diagnostic interpretation because of the large amount of data that is generated. A color-mapping method for 4D-CTA is presented for improved and enhanced visualization of the cerebral vasculature hemodynamics. This method was applied to detect cranial AVFs.&lt;/p&gt;&lt;h3&gt;MATERIALS AND METHODS:&lt;/h3&gt;
&lt;p&gt;All patients who underwent both 4D-CTA and DSA in our hospital from 2011 to 2018 for the clinical suspicion of a cranial AVF or carotid cavernous fistula were retrospectively collected. Temporal information in the cerebral vasculature was visualized using a patient-specific color scale. All color-maps were evaluated by 3 observers for the presence or absence of an AVF or carotid cavernous fistula. The presence or absence of cortical venous reflux was evaluated as a secondary outcome measure.&lt;/p&gt;&lt;h3&gt;RESULTS:&lt;/h3&gt;
&lt;p&gt;In total, 31 patients were included, 21 patients with and 10 without an AVF. Arterialization of venous structures in AVFs was accurately visualized using color-mapping. There was high sensitivity (86%–100%) and moderate-to-high specificity (70%–100%) for the detection of AVFs on color-mapping 4D-CTA, even without the availability of dynamic subtraction rendering. The diagnostic performance of the 3 observers in the detection of cortical venous reflux was variable (sensitivity, 43%–88%; specificity, 60%–80%).&lt;/p&gt;&lt;h3&gt;CONCLUSIONS:&lt;/h3&gt;
&lt;p&gt;Arterialization of venous structures can be visualized using color-mapping of 4D-CTA and proves to be accurate for the detection of cranial AVFs. This finding makes color-mapping a promising visualization technique for assessing temporal hemodynamics in 4D-CTA.&lt;/p&gt;" />
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<meta name="twitter:title" content="Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: 4D CT angiography is increasingly used in clinical practice for the assessment of different neurovascular disorders. Optimized processing of 4D-CTA is crucial for diagnostic interpretation because of the large amount of data that is generated. A color-mapping method for 4D-CTA is presented for improved and enhanced visualization of the cerebral vasculature hemodynamics. This method was applied to detect cranial AVFs.

MATERIALS AND METHODS: All patients who underwent both 4D-CTA and DSA in our hospital from 2011 to 2018 for the clinical suspicion of a cranial AVF or carotid cavernous fistula were retrospectively collected. Temporal information in the cerebral vasculature was visualized using a patient-specific color scale. All color-maps were evaluated by 3 observers for the presence or absence of an AVF or carotid cavernous fistula. The presence or absence of cortical venous reflux was evaluated as a secondary outcome measure.

RESULTS: In total, 31 patients were included, 21 patients with and 10 without an AVF. Arterialization of venous structures in AVFs was accurately visualized using color-mapping. There was high sensitivity (86%–100%) and moderate-to-high specificity (70%–100%) for the detection of AVFs on color-mapping 4D-CTA, even without the availability of dynamic subtraction rendering. The diagnostic performance of the 3 observers in the detection of cortical venous reflux was variable (sensitivity, 43%–88%; specificity, 60%–80%).

CONCLUSIONS: Arterialization of venous structures can be visualized using color-mapping of 4D-CTA and proves to be accurate for the detection of cranial AVFs. This finding makes color-mapping a promising visualization technique for assessing temporal hemodynamics in 4D-CTA.

CCF
:   carotid cavernous fistula
TTS
:   time-to-signal" />
<meta name="og-title" property="og:title" content="Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts" />
<meta name="og-url" property="og:url" content="http://ajnr-stage2.stage.highwire.org/content/40/9/1498" />
<meta name="og-site-name" property="og:site_name" content="American Journal of Neuroradiology" />
<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: 4D CT angiography is increasingly used in clinical practice for the assessment of different neurovascular disorders. Optimized processing of 4D-CTA is crucial for diagnostic interpretation because of the large amount of data that is generated. A color-mapping method for 4D-CTA is presented for improved and enhanced visualization of the cerebral vasculature hemodynamics. This method was applied to detect cranial AVFs.

MATERIALS AND METHODS: All patients who underwent both 4D-CTA and DSA in our hospital from 2011 to 2018 for the clinical suspicion of a cranial AVF or carotid cavernous fistula were retrospectively collected. Temporal information in the cerebral vasculature was visualized using a patient-specific color scale. All color-maps were evaluated by 3 observers for the presence or absence of an AVF or carotid cavernous fistula. The presence or absence of cortical venous reflux was evaluated as a secondary outcome measure.

RESULTS: In total, 31 patients were included, 21 patients with and 10 without an AVF. Arterialization of venous structures in AVFs was accurately visualized using color-mapping. There was high sensitivity (86%–100%) and moderate-to-high specificity (70%–100%) for the detection of AVFs on color-mapping 4D-CTA, even without the availability of dynamic subtraction rendering. The diagnostic performance of the 3 observers in the detection of cortical venous reflux was variable (sensitivity, 43%–88%; specificity, 60%–80%).

CONCLUSIONS: Arterialization of venous structures can be visualized using color-mapping of 4D-CTA and proves to be accurate for the detection of cranial AVFs. This finding makes color-mapping a promising visualization technique for assessing temporal hemodynamics in 4D-CTA.

CCF
:   carotid cavernous fistula
TTS
:   time-to-signal" />
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      <h1 class="highwire-cite-title" id="page-title">Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">M. Meijs</span>, <span class="highwire-citation-author" data-delta="1">S.A.H. Pegge</span>, <span class="highwire-citation-author" data-delta="2">K. Murayama</span>, <span class="highwire-citation-author" data-delta="3">H.D. Boogaarts</span>, <span class="highwire-citation-author" data-delta="4">M. Prokop</span>, <span class="highwire-citation-author" data-delta="5">P.W.A. Willems</span>, <span class="highwire-citation-author" data-delta="6">R. Manniesing</span> and <span class="highwire-citation-author" data-delta="7">F.J.A. Meijer</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">September 2019,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1498-1504; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6156 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-69894--61861149332" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">M. Meijs </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (M.M., S.A.H.P., M.P., R.M., F.J.A.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BMeijs%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Meijs%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BMeijs%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-3014-8749" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Meijs</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">S.A.H. Pegge </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (M.M., S.A.H.P., M.P., R.M., F.J.A.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.A.H.%2BPegge%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Pegge%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.A.H.%2BPegge%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-9314-6137" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.A.H. Pegge</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">K. Murayama </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>c</span>Department of Radiology (K.M.), Fujita Health University, Toyoake, Japan</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.%2BMurayama%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Murayama%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AK.%2BMurayama%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4167-1930" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for K. Murayama</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">H.D. Boogaarts </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Neurosurgery (H.D.B.), Radboud University Medical Center, Nijmegen, the Netherlands</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=H.D.%2BBoogaarts%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Boogaarts%20H&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AH.D.%2BBoogaarts%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-5855-2447" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for H.D. Boogaarts</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">M. Prokop </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (M.M., S.A.H.P., M.P., R.M., F.J.A.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=M.%2BProkop%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Prokop%20M&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AM.%2BProkop%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-8157-8055" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for M. Prokop</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">P.W.A. Willems </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of Neurosurgery (P.W.A.W.), University Medical Center Utrecht, Utrecht, the Netherlands.</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=P.W.A.%2BWillems%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Willems%20P&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AP.W.A.%2BWillems%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-6168-1204" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for P.W.A. Willems</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">R. Manniesing </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>From the Departments of Radiology and Nuclear Medicine (M.M., S.A.H.P., M.P., R.M., F.J.A.M.)</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=R.%2BManniesing%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Manniesing%20R&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AR.%2BManniesing%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0002-4616-6298" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for R. Manniesing</a></li></ul></div><div class="author-tooltip-7"><div class="author-tooltip-name">F.J.A. 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        	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-volume highwire-cite-metadata">Vol. 40</span>, <span  class="highwire-cite-metadata-issue highwire-cite-metadata">Issue 9 </span><div  class="highwire-cite-metadata-pubdate highwire-cite-metadata">1 Sep 2019 </div></div>
      
      
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      <div class="highwire-cite-title">Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Meijs</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">S.A.H.</span> <span class="nlm-surname">Pegge</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Murayama</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">H.D.</span> <span class="nlm-surname">Boogaarts</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Prokop</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">P.W.A.</span> <span class="nlm-surname">Willems</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Manniesing</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">F.J.A.</span> <span class="nlm-surname">Meijer</span></span></span></div>
  
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      <div class="highwire-cite-title">Color-Mapping of 4D-CTA for the Detection of Cranial Arteriovenous Shunts</div>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Meijs</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">S.A.H.</span> <span class="nlm-surname">Pegge</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">K.</span> <span class="nlm-surname">Murayama</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">H.D.</span> <span class="nlm-surname">Boogaarts</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">M.</span> <span class="nlm-surname">Prokop</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">P.W.A.</span> <span class="nlm-surname">Willems</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">R.</span> <span class="nlm-surname">Manniesing</span></span>, <span class="highwire-citation-author" data-delta="7"><span class="nlm-given-names">F.J.A.</span> <span class="nlm-surname">Meijer</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-oa-ind highwire-cite-metadata"><i class="highwire-oa-indicator"></i> </span><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Sep 2019, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">40 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(9) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">1498-1504; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A6156 </span></div>
  
  
  
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