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Value of external carotid artery resistive index for diagnosis of cavernous sinus dural arteriovenous fistula and determination of malignant type

  • Chai Kobkitsuksakul
    Correspondence
    Corresponding author at: Division of Interventional Neuroradiology, Department of Radiology, Ramathibodi Hospital, Mahidol University, 270 Rama 6 Road, Ratchathewi District, Bangkok, Thailand.
    Affiliations
    Division of Interventional Neuroradiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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  • Wasawat Soratcha
    Affiliations
    Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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  • Ekachat Chanthanaphak
    Affiliations
    Division of Interventional Neuroradiology, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
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Published:November 16, 2017DOI:https://doi.org/10.1016/j.clinimag.2017.11.006

      Highlights

      • Sensitivity of the CDS increased with the patients with malignant-typed CSDAVF. This phenomenon was presumably explained by higher flow of the feeding artery, lower arteriovenous pressure gradient in malignant-typed than in benign-typed CSDAVF.
      • Due to the effects of bilateral feeders changed CDS parameters, therefore the abnormalities on the CDS parameters cannot precisely predict the side of shunt.
      • Some patients showed no disturbance on the CDS parameters because of the supplied feeding artery that arrived exclusively from meningeal branches of ICA.

      Abstract

      Purpose

      Cavernous sinus dural arteriovenous fistula (CSDAVF) causes hemodynamic disturbance in the arteries, which is detected by carotid Doppler sonography (CDS). The objective of the study was designed for validation of CDS in the diagnosis of CSDAVF.

      Material and methods

      42 CSDAVF patients confirmed by angiography were enrolled. All patients were performed CDS before angiography. Evaluations of CDS parameters were compared with control subjects.

      Results

      The ECA resistive index (RI) shows the best performance. The highest yield shown on left ECA RI and increased from 78.6% to 91.7% on malignant-typed.

      Conclusion

      CDS may be beneficial as the screening tool for CSDAVF.

      Graphical abstract

      Keywords

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