YEN-HENG LINYU-FEN WANGHON-MAN LIUCHUNG-WEI LEEYA-FANG CHENHsieh H.-J.2020-09-232020-09-2320180028-3940https://scholars.lib.ntu.edu.tw/handle/123456789/514654Purpose: Computed tomography angiography (CTA) and magnetic resonance imaging/angiography (MRI/MRA) are used for the diagnosis of intracranial dural arteriovenous fistulas (DAVFs). The purpose of this study was to compare the diagnostic accuracy of CTA and magnetic resonance imaging/angiography (MRI/MRA) for detection of cortical venous reflux (CVR) in intracranial DAVFs. Methods: The records of patients with angiography-confirmed intracranial DAVFs who also received CTA and MRI/MRA from January 2008 to July 2016 were reviewed. CTA and MRI/MRA were reviewed for signs of CVR, and the diagnostic accuracy of individual signs was evaluated by receiver operating curve (ROC) analysis. Results: A total 108 patients were included in this study. CTA signs of CVR included abnormal dilatation, early enhancement, and the presence of a medullary or pial vein. MRI/MRA signs of CVR included abnormal dilatation, early enhancement, flow-related enhancement, flow void, and medullary or pial venous collaterals. The sensitivity of individual CTA signs ranged from 62 to 96%, and specificities from 79 to 94%. The sensitivities of individual MRI/MRA signs ranged from 58 to 83%, and specificities from 77 to 93%. The area under ROC curve (AUC) of CTA and MRI/MRA were 0.91 and 0.87, respectively (P = 0.04 in direct comparison). In subgroup analysis, CTA had better diagnostic accuracy for higher grade disease (P = 0.05) and non-aggressive manifestation (P = 0.04). Conclusions: Both CTA and MRI/MRA have good diagnostic accuracy for detection of CVR in patients with intracranial DAVFs. There is modest evidence that CTA is better than MRI/MRA. ? 2017, Springer-Verlag GmbH Germany, part of Springer Nature.[SDGs]SDG3iopromide; contrast medium; adult; Article; blood flow; computed tomographic angiography; contrast enhancement; diagnostic accuracy; diagnostic test accuracy study; dural arteriovenous fistula; female; human; image analysis; intermethod comparison; magnetic resonance angiography; major clinical study; male; middle aged; nuclear magnetic resonance imaging; priority journal; receiver operating characteristic; retrospective study; sensitivity and specificity; vasodilatation; venous reflux; aged; brain angiography; brain arteriovenous malformation; central nervous system malformation; diagnostic imaging; Adult; Aged; Central Nervous System Vascular Malformations; Cerebral Angiography; Computed Tomography Angiography; Contrast Media; Female; Humans; Intracranial Arteriovenous Malformations; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Male; Middle Aged; Retrospective Studies; Sensitivity and Specificityjournal article10.1007/s00234-017-1948-2291883042-s2.0-85035341755