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Arterial spin labeling MR imaging aids to identify cortical venous drainage of dural arteriovenous fistulas.

Abstract Cortical venous drainage (CVD) increases the probability of intracranial hemorrhage and mortality rate of dural arteriovenous fistulas (DAVF). Although digital subtraction angiography (DSA) is the most accurate method to determine CVD in DAVFs, this modality has limitations due to its invasive nature and radiation issues. The purpose of this study was to evaluate the diagnostic utility of arterial spin-labeling perfusion-weighted images (ASL-PWI) to identify CVD in patients with DAVF.The Institutional Review Board of our hospital approved this retrospective study. ASL-PWI features of 22 patients with DAVF were retrospectively reviewed for the presence of bright signal intensity in cortical veins and brain parenchyma. DAVF with bright signal intensity in cortical veins and/or brain parenchyma was regarded as having CVD. Using DSA as a reference standard, sensitivity, specificity, positive predictive value, and negative predictive value of ASL-PWI for detecting CVD were calculated.Based on DSA features, 11 (11/22, 50%) patients were classified as having "aggressive" pattern with CVD. Eleven (11/22, 50%) patients also showed bright signal intensity in cortical veins (9/22, 41%) and/or brain parenchyma (4/22, 18%) on ASL-PWI. The 11 patients who had "Aggressive" pattern on DSA were the same 11 patients who were classified as having "aggressive" pattern on ASL-PWI. ASL-PWI showed perfect diagnostic performance for identifying CVD with sensitivity, specificity, positive predictive value, and negative predictive value of 100% for all.Thus, ASL-PWI could be used as a noninvasive mean to predict the presence of CVD in patients with DAVFs. It has the potential as a screening tool to evaluate DAVF prior to invasive DSA.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title medicine
Publication Year Start




PMID- 29742722
OWN - NLM
STAT- MEDLINE
DCOM- 20180516
LR  - 20180516
IS  - 1536-5964 (Electronic)
IS  - 0025-7974 (Linking)
VI  - 97
IP  - 19
DP  - 2018 May
TI  - Arterial spin labeling MR imaging aids to identify cortical venous drainage of
      dural arteriovenous fistulas.
PG  - e0697
LID - 10.1097/MD.0000000000010697 [doi]
AB  - Cortical venous drainage (CVD) increases the probability of intracranial
      hemorrhage and mortality rate of dural arteriovenous fistulas (DAVF). Although
      digital subtraction angiography (DSA) is the most accurate method to determine
      CVD in DAVFs, this modality has limitations due to its invasive nature and
      radiation issues. The purpose of this study was to evaluate the diagnostic
      utility of arterial spin-labeling perfusion-weighted images (ASL-PWI) to identify
      CVD in patients with DAVF.The Institutional Review Board of our hospital approved
      this retrospective study. ASL-PWI features of 22 patients with DAVF were
      retrospectively reviewed for the presence of bright signal intensity in cortical 
      veins and brain parenchyma. DAVF with bright signal intensity in cortical veins
      and/or brain parenchyma was regarded as having CVD. Using DSA as a reference
      standard, sensitivity, specificity, positive predictive value, and negative
      predictive value of ASL-PWI for detecting CVD were calculated.Based on DSA
      features, 11 (11/22, 50%) patients were classified as having "aggressive" pattern
      with CVD. Eleven (11/22, 50%) patients also showed bright signal intensity in
      cortical veins (9/22, 41%) and/or brain parenchyma (4/22, 18%) on ASL-PWI. The 11
      patients who had "Aggressive" pattern on DSA were the same 11 patients who were
      classified as having "aggressive" pattern on ASL-PWI. ASL-PWI showed perfect
      diagnostic performance for identifying CVD with sensitivity, specificity,
      positive predictive value, and negative predictive value of 100% for all.Thus,
      ASL-PWI could be used as a noninvasive mean to predict the presence of CVD in
      patients with DAVFs. It has the potential as a screening tool to evaluate DAVF
      prior to invasive DSA.
FAU - Kang, Ji Hee
AU  - Kang JH
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Yun, Tae Jin
AU  - Yun TJ
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Rhim, Jong Kook
AU  - Rhim JK
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Cho, Young Dae
AU  - Cho YD
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Yoo, Dong Hyun
AU  - Yoo DH
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Yoo, Roh-Eul
AU  - Yoo RE
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Kang, Koung Mi
AU  - Kang KM
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Choi, Seung Hong
AU  - Choi SH
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Kim, Ji-Hoon
AU  - Kim JH
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Sohn, Chul-Ho
AU  - Sohn CH
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
FAU - Han, Moon Hee
AU  - Han MH
AD  - Institute of Radiation Medicine, Seoul National University Medical Research
      Center.
AD  - Department of Radiology, Seoul National University Hospital, Seoul, Republic of
      Korea.
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Medicine (Baltimore)
JT  - Medicine
JID - 2985248R
RN  - 0 (Spin Labels)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Angiography, Digital Subtraction
MH  - Central Nervous System Vascular Malformations/*diagnostic imaging
MH  - Cerebral Veins/*diagnostic imaging
MH  - Female
MH  - Humans
MH  - Magnetic Resonance Angiography/*methods
MH  - Male
MH  - Middle Aged
MH  - Reference Standards
MH  - Spin Labels
MH  - Young Adult
EDAT- 2018/05/10 06:00
MHDA- 2018/05/17 06:00
CRDT- 2018/05/10 06:00
PHST- 2018/05/10 06:00 [entrez]
PHST- 2018/05/10 06:00 [pubmed]
PHST- 2018/05/17 06:00 [medline]
AID - 10.1097/MD.0000000000010697 [doi]
AID - 00005792-201805110-00041 [pii]
PST - ppublish
SO  - Medicine (Baltimore). 2018 May;97(19):e0697. doi: 10.1097/MD.0000000000010697.