Dural arteriovenous fistula: Diagnosis, treatment, and outcomes

Abstract

A DAVF is a vascular lesion that is best diagnosed with conventional angiography, but can often be found with MRA. Treatment with endovascular embolization is effective and has few significant complications.

CT Angiography as a Screening Tool for Dural Arteriovenous Fistula in Patients with Pulsatile Tinnitus: Feasibility and Test Characteristics

“…The discrepancy between the current results and the findings of Cohen et al, 21 however, does require further discussion. In that series of 46 patients, 13 patients underwent CTA, only 2 of whom had findings positive for DAVF.…”

“…21,28,29 Studies have used a variety of techniques and sequences and have shown variable diagnostic performance. De Marco et al 28 presented some of the earliest data, finding MR imaging cortical vein dilation and venous occlusion in 8 of 12 patients with angiographically proved DAVF by using basic spin-and gradient-echo sequences.…”

“…21,29 Time-resolved MR imaging and 4D flow MR imaging have shown promise in providing angiography-like images 30,31 and in providing the time resolution that routine CTA/CTV and MR imaging/MRA/MRV lack. Yet these studies represent the results of highly specialized and often proprietary MR images, which, as such, remain in limited use.…”

“…Using CTA/CTV, Krishnan et al 16 evaluated 16 patients with PT and, somewhat surprising, did not identify a single DAVF. More recently, in a retrospective review of patients with DAVF, Cohen et al 21 found a low sensitivity (15.4%) of CTA for DAVF, but these authors did not describe how the CTAs were evaluated. In this study, we propose and depict a set of CTA findings that suggests the presence of DAVF in patients with PT, and we evaluate the diagnostic performance of these findings as a screening tool for DAVF in patients with PT.…”

Intracranial Dural Arteriovenous Fistulas: Classification, Imaging Findings, and Treatment

“…35,36 Studies have reported, however, that CTA has reduced sensitivity versus MRA for the detection of DAVFs (15.4% versus 50%). 37 Time-resolved MRA techniques are also promising and may be reliable for DAVF screening and surveillance in the future. 38,39 Due to current limitations of low resolution, restricted FOV, and saturation artifacts, the negative predictive value of MRA is inadequate to exclude DAVFs.…”