Abstract：
BACKGROUND: A non-invasive, reliable imaging modality that characterizes cavernous sinus dural arteriovenous fistula (CSDAVF) is beneficial for diagnosis and to assess resolution on follow-up.
OBJECTIVE: To assess the utility of 3D time-of-flight (TOF) and silent magnetic resonance angiography (MRA) for evaluation of CSDAVF from an endovascular perspective.
METHODS: This prospective study included 37 patients with CSDAVF, who were subjected to digital subtraction angiography (DSA) and 3-T MR imaging with 3D TOF and silent MRA. The main arterial feeders, fistula site, and venous drainage pattern were evaluated, and the results were compared with DSA findings. The diagnostic confidence scores were also recorded using a 4-point Likert scale.
RESULTS: Silent MRA correlated better for shunt site localization and angiographic classification (86% vs. 75% and 83% vs. 75%, respectively) compared to TOF MRA. The proportion of arterial feeders detected was marginally significant for silent MRA over TOF MRA sequences (92.8% vs. 89.5%; P=0.048), though for veins both were comparable. Sensitivity of silent MRA was higher for identification of cortical venous reflux (CVR) (90.9% vs. 81.8%) and deep venous drainage (82.4% vs. 64.7%), while specificity was >90% for both modalities. The overall diagnostic confidence score fared better for silent MRA for venous assessment (P < 0.001) as well as fistula point identification (P < 0.001), while no significant difference was evident with TOF MRA for arterial feeders (P=0.06).
CONCLUSIONS: Various angiographic components of CSDAVF could be identified and delineated by 3D TOF and silent MRA, though silent MRA was superior for overall diagnostic assessment.
OBJECTIVE: To assess the utility of 3D time-of-flight (TOF) and silent magnetic resonance angiography (MRA) for evaluation of CSDAVF from an endovascular perspective.
METHODS: This prospective study included 37 patients with CSDAVF, who were subjected to digital subtraction angiography (DSA) and 3-T MR imaging with 3D TOF and silent MRA. The main arterial feeders, fistula site, and venous drainage pattern were evaluated, and the results were compared with DSA findings. The diagnostic confidence scores were also recorded using a 4-point Likert scale.
RESULTS: Silent MRA correlated better for shunt site localization and angiographic classification (86% vs. 75% and 83% vs. 75%, respectively) compared to TOF MRA. The proportion of arterial feeders detected was marginally significant for silent MRA over TOF MRA sequences (92.8% vs. 89.5%; P=0.048), though for veins both were comparable. Sensitivity of silent MRA was higher for identification of cortical venous reflux (CVR) (90.9% vs. 81.8%) and deep venous drainage (82.4% vs. 64.7%), while specificity was >90% for both modalities. The overall diagnostic confidence score fared better for silent MRA for venous assessment (P < 0.001) as well as fistula point identification (P < 0.001), while no significant difference was evident with TOF MRA for arterial feeders (P=0.06).
CONCLUSIONS: Various angiographic components of CSDAVF could be identified and delineated by 3D TOF and silent MRA, though silent MRA was superior for overall diagnostic assessment.
摘要：
背景：非侵入性，以海绵窦硬脑膜动静脉瘘(CSDAVF)为特征的可靠影像学检查方法有助于诊断和评估随访时的分辨率.
目的：从血管内角度评估3D飞行时间（TOF）和无声磁共振血管造影（MRA）在评估CSDAVF中的实用性。
方法：这项前瞻性研究包括37例CSDAVF患者，他们接受了数字减影血管造影（DSA）和3DTOF和无声MRA的3-TMR成像。主要的动脉喂食器，瘘管部位,和静脉引流模式进行了评估，并将结果与DSA结果进行比较。还使用4点Likert量表记录诊断置信度得分。
结果：沉默MRA与分流部位定位和血管造影分类的相关性更好（86％vs.75%和83%与75%,分别)与TOFMRA相比。对于TOFMRA序列的沉默MRA，检测到的动脉饲养者的比例略显着（92.8％vs.89.5%;P=0.048),虽然对于静脉来说两者都是可比的。沉默MRA对识别皮质静脉回流（CVR）的敏感性更高（90.9％vs.81.8%)和深静脉引流(82.4%vs.64.7%），而两种模式的特异性均>90%。对于静脉评估（P<0.001）和瘘点识别（P<0.001），无声MRA的总体诊断置信度评分较好，而动脉饲养者的TOFMRA没有显着差异（P=0.06）。
结论：CSDAVF的各种血管造影成分可以通过3DTOF和无声MRA来识别和描绘，尽管沉默MRA在总体诊断评估方面优于常规。
目的：从血管内角度评估3D飞行时间（TOF）和无声磁共振血管造影（MRA）在评估CSDAVF中的实用性。
方法：这项前瞻性研究包括37例CSDAVF患者，他们接受了数字减影血管造影（DSA）和3DTOF和无声MRA的3-TMR成像。主要的动脉喂食器，瘘管部位,和静脉引流模式进行了评估，并将结果与DSA结果进行比较。还使用4点Likert量表记录诊断置信度得分。
结果：沉默MRA与分流部位定位和血管造影分类的相关性更好（86％vs.75%和83%与75%,分别)与TOFMRA相比。对于TOFMRA序列的沉默MRA，检测到的动脉饲养者的比例略显着（92.8％vs.89.5%;P=0.048),虽然对于静脉来说两者都是可比的。沉默MRA对识别皮质静脉回流（CVR）的敏感性更高（90.9％vs.81.8%)和深静脉引流(82.4%vs.64.7%），而两种模式的特异性均>90%。对于静脉评估（P<0.001）和瘘点识别（P<0.001），无声MRA的总体诊断置信度评分较好，而动脉饲养者的TOFMRA没有显着差异（P=0.06）。
结论：CSDAVF的各种血管造影成分可以通过3DTOF和无声MRA来识别和描绘，尽管沉默MRA在总体诊断评估方面优于常规。
