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RT Journal Article
SR Electronic
T1 Assessment of 4D MR Angiography at 3T Compared with DSA for the Follow-up of Embolized Brain Dural Arteriovenous Fistula: A Dual-Center Study
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 340
OP 346
DO 10.3174/ajnr.A6903
VO 42
IS 2
A1 Dissaux, B.
A1 Eugène, F.
A1 Ognard, J.
A1 Gauvrit, J.-Y.
A1 Gentric, J.-C.
A1 Ferré, J.-C.
YR 2021
UL http://www.ajnr.org/content/42/2/340.abstract
AB BACKGROUND AND PURPOSE: 4D contrast-enhanced MRA in the follow-up of treated dural arteriovenous fistulas has rarely been evaluated. Our aim was to evaluate its diagnostic performance at 3T in the follow-up of embolized dural arteriovenous fistulas using DSA as the standard of reference.MATERIALS AND METHODS: Patients treated for dural arteriovenous fistulas in 2 centers between 2008 and 2019 were included if they met the following criteria: 1) dural arteriovenous fistula embolization, and 2) follow-up imaging with &lt;6 months between DSA and 4D contrast-enhanced MRA. Two readers reviewed the 4D contrast-enhanced MRA images, first independently, then in consensus to detect any residual/recurrent dural arteriovenous fistula and to grade cases according to the Cognard classification system. Interobserver and intermodality agreement for the detection of a residual dural arteriovenous fistula and stratification of bleeding risk (0-I-IIa; IIb-IIa+b-III-IV-V) was calculated using κ coefficients.RESULTS: A total of 51 pairs of examinations for 44 patients (median age, 65 years; range, 25–81 years) were analyzed. Interobserver agreement for the detection and stratification of bleeding risk was, respectively, κ = 0.8 (95% CI, 0.6–1) and κ = 0.8 (95% CI, 0.5–1). After consensus review, the sensitivity and specificity of 4D contrast-enhanced MRA for the detection of residual/recurrent dural arteriovenous fistula was 63.6% (95% CI, 40.7%–82.8%) and 96.6% (95% CI, 82.2%–99.9%), respectively. The positive and negative predictive values of 4D contrast-enhanced MRA were 93.3% (95% CI, 68.1%–99.8%) and 77.8% (95% CI, 60.8%–89.9%). Intermodality agreement for the detection and stratification of bleeding risk was good, with κ = 0.60 (95% CI, 0.3–0.8).CONCLUSIONS: 4D contrast-enhanced MRA at 3T is of interest in the follow-up of treated dural arteriovenous fistulas but lacks the sensitivity to replace arteriography.DAVFdural arteriovenous fistula4D-MRA4D contrast-enhanced magnetic resonance angiography