Journal article
The Position and Role of Four-Dimensional Computed Tomography Angiography in the Diagnosis and Treatment of Spinal Arteriovenous Fistulas
World neurosurgery, Vol.103, pp.611-619
07/2017
DOI: 10.1016/j.wneu.2017.03.100
PMID: 28366753
Abstract
Localization of the arteriovenous fistula (AVF) is a crucial step in the diagnosis and treatment of spinal vascular malformations (VMs). Noninvasive angiographic techniques such as dynamic magnetic resonance angiography and three-dimensional computed tomography angiography (CTA) have been used as standard modalities to localize AVF. With the increasing prevalence of high-specification computed tomography scanners, four-dimensional (4D) CTA is being increasingly used in the evaluation of cerebrovascular disorders. However, application of 4D-CTA in spinal lesions has been limited. The position and role of 4D-CTA, among various modalities, in the evaluation of spinal VMs has not been elucidated.
We retrospectively review our clinical experience with 4D-CTA used for spinal AVFs. 4D-CTA images were acquired in 10 cases of spinal VMs consisting of 8 dural/epidural AVFs and 2 perimedullary AVFs. Imaging findings of 4D-CTA and digital subtraction angiography were reviewed to validate the usefulness of 4D-CTA.
In 9 of 10 cases, 4D-CTA accurately localized the AVF. The scan visualized direction of flow in the perimedullary veins in all cases. Regarding perimedullary AVFs, 4D-CTA showed dynamic images of feeding arteries, AVF, and perimedullary drainage. Information provided by 4D-CTA was beneficial as a reference in subsequent DSA.
In the diagnostic process of spinal VMs, the position of 4D-CTA is the third choice for noninvasive angiography, after dynamic MRA and three-dimensional CTA. However, the role of 4D-CTA might be decisive in difficult-to-find spinal dural AVFs. We believe that this novel imaging technique can be applied in spinal VMs.
Details
- Title: Subtitle
- The Position and Role of Four-Dimensional Computed Tomography Angiography in the Diagnosis and Treatment of Spinal Arteriovenous Fistulas
- Creators
- Satoshi Yamaguchi - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JapanKohei Takemoto - Technical Division of Diagnostic Imaging, Itsukaichi Memorial Hospital, Hiroshima, JapanMasaaki Takeda - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JapanYosuke Kajihara - Department of Neurosurgery, Itsukaichi Memorial Hospital, Hiroshima, JapanTakafumi Mitsuhara - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JapanManish Kolakshyapati - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, JapanKazutoshi Mukada - Department of Neurosurgery, Itsukaichi Memorial Hospital, Hiroshima, JapanKaoru Kurisu - Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan
- Resource Type
- Journal article
- Publication Details
- World neurosurgery, Vol.103, pp.611-619
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.wneu.2017.03.100
- PMID
- 28366753
- ISSN
- 1878-8750
- eISSN
- 1878-8769
- Language
- English
- Date published
- 07/2017
- Academic Unit
- Neurosurgery
- Record Identifier
- 9984040267802771
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