Arterial Spin-Labeling Improves Detection of Intracranial Dural Arteriovenous Fistulas with MRI
Autor: | Nancy J. Fischbein, Michael P. Marks, Gregory Zaharchuk, Roland Bammer, Shalini A. Amukotuwa, Fernando Calamante |
---|---|
Rok vydání: | 2018 |
Předmět: |
Adult
Male Arteriovenous fistula Neuroimaging Sensitivity and Specificity Article 030218 nuclear medicine & medical imaging 03 medical and health sciences Imaging Three-Dimensional 0302 clinical medicine Dural arteriovenous fistulas medicine Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Central Nervous System Vascular Malformations medicine.diagnostic_test Receiver operating characteristic analysis Receiver operating characteristic business.industry Magnetic resonance imaging Middle Aged medicine.disease Magnetic Resonance Imaging ROC Curve Angiography Arterial spin labeling Female Spin Labels Neurology (clinical) business Nuclear medicine 030217 neurology & neurosurgery |
Zdroj: | American Journal of Neuroradiology. 39:669-677 |
ISSN: | 1936-959X 0195-6108 |
Popis: | BACKGROUND AND PURPOSE: Intracranial dural arteriovenous fistulas carry a risk of substantial neurologic complications but can be difficult to detect on structural MR imaging and TOF-MRA. The purpose of this study was to assess the accuracy and added value of 3D pseudocontinuous arterial spin-labeling MR imaging for the detection of these lesions. MATERIALS AND METHODS: This retrospective study included 39 patients with a dural arteriovenous fistula and 117 controls who had undergone both DSA and MR imaging with pseudocontinuous arterial spin-labeling. Two neuroradiologists blinded to the DSA results independently assessed MR imaging with and without pseudocontinuous arterial spin-labeling. They recorded specific signs, including venous arterial spin-labeling signal, and the likelihood of a dural arteriovenous fistula using a 5-point Likert scale. Logistic regression and receiver operating characteristic analyses were performed to determine the accuracy of specific signs and the added value of pseudocontinuous arterial spin-labeling. Interobserver agreement was determined by using κ statistics. RESULTS: Identification of the venous arterial spin-labeling signal had a high sensitivity (94%) and specificity (88%) for the presence a dural arteriovenous fistula. Receiver operating characteristic analysis showed significant improvement in diagnostic performance with the addition of pseudocontinuous arterial spin-labeling in comparison with structural MR imaging (Δarea under the receiver operating characteristic curve = 0.179) and a trend toward significant improvement in comparison with structural MR imaging with time-of-flight MRA (Δarea under the receiver operating characteristic curve = 0.043). Interobserver agreement for the presence of a dural arteriovenous fistula improved substantially and was almost perfect with the addition of pseudocontinuous arterial spin-labeling (κ = 0.92). CONCLUSIONS: Venous arterial spin-labeling signal has high sensitivity and specificity for the presence of a dural arteriovenous fistula, and the addition of pseudocontinuous arterial spin-labeling increases confidence in the diagnosis of this entity on MR imaging. |
Databáze: | OpenAIRE |
Externí odkaz: |