| Purpose:To evaluate the value of four-dimensional computed tomography angiography (4D-CTA) in diagnosis of cerebral arteriovenous malformation (CAVM).Methods:40patients, diagnosed of CAVM by DSA were included in this research.320-detector row CT scanner had been used to perform4D-CTA. All results of4D-CTA were documented in a standardized scoring sheet, and the data were blind to the results of DSA examinations. SPSS17.0statistical software was used for data processing.4D-CTA and DSA results were assessed using Kappa consistency test to evaluate the ability of detecting the size of the nidus,draining veins and feeding arteries. Kappa coefficient<0.40indicates poor consistency,0.41-0.60the consistency medium,0.61-0.80indicates consistency,>0.80indicates excellent consistency, P<0.05is considered statistically significant. The best phases showing feeding arteries were chosen as3D-CTA images.4D-CTA and3D-CTA results were assessed using chi-square test to evaluate the accuracy rate of detecting feeding arteries and draining veins.Results:1,37of40cases of CTA image had grade I quality, the rest3were both grade II.2, The results of4D-CTA in all40cases were fully consistent with DSA in location and size of CAVM (K=1).3, DSA detected118CAVM blood supply arteries, while4D-CTA detected114arteries. There was excellent consistency between4D-CTA and DSA.(k=0.89, P<0.05).4, All the venous drainage of CAVM were shown clearly by the4D-CTA. The position and direction of the drainage vein can also be correctly judged. And4D-CTA was superior to DSA for a wide range of display. There was excellent consistency between two methods,(k=0.95, P<0.05).5,The accuracy of feeding arteries detected by4D-CTA and3D-CTA was95%.87.3%,and the accuracy of draining veins was97.6%,85.7%.The accuracy of feeding arteries and draining veins detected by4D-CTA and3D-CTA was statistically different.6,4D-CTA was sensitive to show concurrent brain lesions. In this study, we checked out the brain hematoma in22cases,4cases of concurrent aneurysms.Conclusion:1,4D-CTA can share good quality images,is a simple and safe imaging method to diagnose CAVM.For the same patient,4D-CTA is better than3D-CTA in detecting supply arteries and drainage veins.2, If for the purpose of diagnosis,4D-CTA can replace DSA. |
