European Radiology

, Volume 22, Issue 2, pp 429–438 | Cite as

Detection and grading of dAVF: prospects and limitations of 3T MRI

  • Andrea BinkEmail author
  • Joachim Berkefeld
  • Marlies Wagner
  • Se-Jong You
  • Hanns Ackermann
  • Matthias W. Lorenz
  • Christian Senft
  • Richard du Mesnil de Rochemont



DSA is currently the criterion standard for the assessment of dural arteriovenous fistulas (dAVF). Recently, evolving MRA techniques have emerged as a non-invasive alternative. The aim of this study is to assess the value of 3 T MRI in detecting and describing dAVF and to determine whether MRI can replace DSA as diagnostic procedure.


A total of 19 patients with dAVF and 19 without dAVF underwent the same MRI protocol, including 3D time-of-flight MRA and time-resolved contrast-enhanced MRA. The images were evaluated retrospectively by three independent readers with different levels of experience blinded to clinical information. The readers assessed the presence, the site, the venous drainage and the feeders of dAVF. Sensitivity, specificity, accuracy, intertechnique and interobserver agreements were calculated.


DAVF can be detected with high sensitivity, specificity and accuracy by experienced and also by less experienced readers. However, MRI has limitations when used for grading and evaluation of the angioarchitecture of the dAVF. Different experience, the limited resolution of MRI and its inability to selectively display arteries were the reasons for these limitations.


With MRI dAVF can be detected reliably. Nevertheless, at present MRI can not fully replace DSA, especially for treatment planning.


Dural arteriovenous fistula Time-resolved contrast-enhanced MR angiography MRI Digital subtraction angiography DSA 



The authors thank Marina Heibel, Stefanie Pellikan and Lars Göttig for their technical support.


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Copyright information

© European Society of Radiology 2011

Authors and Affiliations

  • Andrea Bink
    • 1
    Email author
  • Joachim Berkefeld
    • 1
  • Marlies Wagner
    • 1
  • Se-Jong You
    • 1
  • Hanns Ackermann
    • 2
  • Matthias W. Lorenz
    • 3
  • Christian Senft
    • 4
  • Richard du Mesnil de Rochemont
    • 1
  1. 1.Department of NeuroradiologyJohann Wolfgang Goethe UniversityFrankfurt am MainGermany
  2. 2.Institute of Biostatistics and Mathematical ModelingJohann Wolfgang Goethe UniversityFrankfurt/MainGermany
  3. 3.Department of NeurologyJohann Wolfgang Goethe UniversityFrankfurt/MainGermany
  4. 4.Department of NeurosurgeryJohann Wolfgang Goethe UniversityFrankfurt/MainGermany

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