Abstract
Background and Purpose: Patients with higher Spetzler-Martin grade cerebral arteriovenous malformations (AVMs) are associated with poorer neurologic and clinical outcomes. Four dimensional computed tomography angiography (4D-CTA) is newly and promising technique in the diagnosis of patients with cerebral arteriovenous malformations (AVMs). The purpose of this retrospective study was to investigate the utility of 4D-CTA using whole-brain 320- detector row CT for assessing cerebral AVMs compared with conventional angiography (CA). Materials & Methods: Participants comprised patients admitted to our institution from November 2010 to March 2012 due to cerebral AVMs, who underwent both 4D-CTA and CA within 14days. The diagnosis of AVM was finally confirmed by CA. Two readers reviewed 4D-CTA and CA under consensus regarding detection rate of the AVMs, each component of the AVMs (feeders, nidi, drainers) which was scored using four-point grading scale (excellent=3, good=2, fair=1, poor=0), and the Spetzler-Martin (S-M) grade. Results: During study periods, eleven patients met our criteria. In every case, cerebral AVM was diagnosed by 4D-CTA. The average score for feeders, nidi, and drainers was 2.0, 2.3, and 2.5 in 4D-CTA and 2.4, 2.6, and 2.7 in CA, respectively. The average score of S-M grade was both 2.0, and matched in 11/11 patients. There were no significant differences statistically between two modalities (P<.005). Conclusion: 4D-CTA using 320-detector row CT is a very reliable method and offered diagnostic performance equivalent to CA in detecting and predicting S-M classification of cerebral AVMs.
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