Arterial Spin-Labeling Improves Detection of Intracranial Dural Arteriovenous Fistulas with MRI.
Arterial Spin-Labeling Improves Detection of Intracranial Dural Arteriovenous Fistulas with MRI.
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DOI：
10.3174/ajnr.a5570
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发表时间：
2018-04
期刊：
影响因子：
--
通讯作者：
Fischbein N
中科院分区：
文献类型：
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作者：
Amukotuwa SA;Marks MP;Zaharchuk G;Calamante F;Bammer R;Fischbein N
Intracranial dAVFs carry a risk of significant neurological complication but can be difficult to detect on structural MRI and TOF-MRA. The purpose of this study was to assess the accuracy and added value of 3D pseudocontinuous arterial spin labeling (PCASL) MRI for detection of these lesions. This retrospective study included 39 patients with a dAVF and 117 controls who had undergone both DSA and MRI with PCASL. Two neuroradiologists blinded to the DSA results independently assessed MRI with and without PCASL. They recorded specific signs, including venous ASL signal, and the likelihood of a dAVF 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 PCASL. Interobserver agreement was determined using k statistics. Identification of venous ASL signal had a high sensitivity (94%) and specificity (88%) for the presence a dAVF. Receiver operating characteristic analysis showed significant improvement in diagnostic performance with addition of PCASL in comparison with structural MRI (Δarea under the curve 0.179) and a trend toward significant improvement in comparison with structural MRI with time-of-flight MRA (Δarea under the curve 0.043). Interobserver agreement for the presence of a dAVF improved substantially and was almost perfect with addition of PCASL (κ 0.92). Venous ASL signal has high sensitivity and specificity for the presence of a dural arteriovenous fistula and the addition PCASL increases confidence in the diagnosis of this entity on MRI.
