Screen for intracranial dural arteriovenous fistulae with carotid duplex sonography
Journal
Journal of Neurology, Neurosurgery and Psychiatry
Journal Volume
80
Journal Issue
11
Pages
1225-1229
Date Issued
2009
Author(s)
Abstract
Objectives: Early diagnosis and management of intracranial dural arteriovenous fistulae (DAVF) may prevent the occurrence of stroke. This study aimed to identify the best carotid duplex sonography (CDS) parameters for screening DAVF. Methods: 63 DAVF patients and 170 non-DAVF patients received both CDS and conventional angiography. The use of seven CDS haemodynamic parameter sets related to the resistance index (RI) of the external carotid artery (ECA) for the diagnosis of DAVF was validated and the applicability of the best CDS parameter set in 20 400 patients was tested. Results: The CDS parameter set (ECA RI (cut-off point = 0.7) and internal carotid artery (ICA) to ECA RI ratio (cut-off point = 0.9)) had the highest specificity (99%) for diagnosis of DAVF with moderate sensitivity (51%). Location of the DAVF was a significant determinant of sensitivity of detection, which was 70% for non-cavernous DAVF and 0% for cavernous sinus DAVF (p<0.001). The above parameter set detected abnormality in 92 of 20 400 patients. These abnormalities included DAVF (n = 25), carotid stenosis (n = 32), vertebral artery stenosis (n = 7), intracranial arterial stenosis (n = 6), head and neck tumour (n = 3) and unknown aetiology (n = 19). Conclusion: Combined CDS parameters of ECA RI and ICA to ECA RI ratio can be used as a screening tool for the diagnosis of DAVF.
SDGs
Other Subjects
adult; aged; artery resistance; article; brain arteriovenous malformation; brain vascular resistance; carotid arteriography; carotid artery obstruction; cavernous sinus; common carotid artery; controlled study; conventional angiography; diagnostic accuracy; dural arteriovenous fistula; external carotid artery; female; head and neck tumor; hemodynamic parameters; human; intermethod comparison; internal carotid artery; major clinical study; male; middle cerebral artery; middle cerebral artery occlusion; occlusive cerebrovascular disease; priority journal; screening test; vertebral artery stenosis; Adult; Angiography; Carotid Artery, External; Central Nervous System Vascular Malformations; Female; Humans; Male; Middle Aged; Sensitivity and Specificity; Ultrasonography, Doppler, Duplex
Type
journal article