The diagnosis of arteriovenous malformations by 4D-CTA: a clinical study

Abstract

Background and purpose: Digital subtraction angiography (DSA) is the current imaging 'gold standard' for diagnosis of arteriovenous malformation (AVM). The latest technique, four-dimensional computed tomography (4D-CT), offers a new diagnostic method for assessing AVM in real time. This study used a 320-detector-row CT scanner to compare the value of 4D-CT angiography (4D-CTA) with DSA in the diagnosis of untreated AVM patients.

Methods: Seventeen patients diagnosed with AVM by DSA were included in this study. Two independent readers blind to the results of all examinations evaluated the findings of DSA and 4D-CTA in each patient. All results were then documented using a standardized scoring sheet.

Results: The results of 4D-CTA in all 17 cases were fully consistent with DSA for AVM location, size and vascular structures. 4D-CTA had the same ability as DSA to distinguish the main feeding arteries in all cases, although in the identification of smaller and specific arterial branches, there were discrepancies in one patient between the two methods. In the diagnosis of draining veins, however, 4D-CTA successfully displayed all of the vessels found by DSA.

Conclusion: 4D-CTA was able to detect all AVM lesions, including their size, location, feeding arteries and draining veins. Thus, 4D-CTA has a value similar to that of DSA in the diagnosis and assessment of AVM.

Keywords: 4D-CTA; AVM; Arteriovenous malformation; DSA; Diagnostic methods.