PMID- 25106829
OWN - NLM
STAT- MEDLINE
DCOM- 20151117
LR  - 20170908
IS  - 1532-8511 (Electronic)
IS  - 1052-3057 (Linking)
VI  - 23
IP  - 8
DP  - 2014 Sep
TI  - A simple score (AVFS) to identify spinal dural arteriovenous fistula before 
      spinal digital subtraction angiography.
PG  - 1995-2000
LID - S1052-3057(14)00052-4 [pii]
LID - 10.1016/j.jstrokecerebrovasdis.2014.01.021 [doi]
AB  - BACKGROUND: Spinal dural arteriovenous fistula (SDAVF) is a rare disorder with 
      the presenting of nonspecific clinical symptoms and signs at onset, which can be 
      a challenge to diagnose promptly and leads to the overusing of spinal digital 
      subtraction angiography (SpDSA) in clinical practice. The purpose of this study 
      was to find specific characteristics of SDAVF by comparing the clinical and 
      radiologic data between the SpDSA-identified patients with SDAVF and 
      SpDSA-negative patients, who were suspected with spinal vascular diseases before 
      admission. METHODS: From 2006 to 2011, patients presented to Huashan hospital 
      with spinal symptoms and who received SpDSA were retrospectively analyzed. 
      Comparisons of clinical and magnetic resonance imaging data were performed 
      between SpDSA-identified SDAVF and SpDSA-negative patients. We derived a 
      diagnostic criteria score and assessed likely clinical usefulness to predict the 
      SDAVF using the score to stratify all patients with suspected. RESULTS: Four 
      independent predictors (age >/=50 years, length of intramedullary lesion >/=5 
      vertical segments, perimedullary dilated vessels, and subcervical lesion) tested 
      out by multivariable logistic regression and receiver operating characteristic 
      analysis were significantly associated with SDAVF. A 4-point score (AVFS) 
      including those criteria predicted the SpDSA-identified SDAVF with an area under 
      the curve of .91 (95% confidence interval [CI] .84-.97, P < .001). A threshold of 
      AVFS of 3 or more predicted SDAVF with a sensitivity of 85% (95% CI 62%-96%) and 
      a specificity of 97% (95% CI 86%-99%). CONCLUSION: The AVFS score may be useful 
      in routine clinical practice to identify high-risk individuals with SDAVF who 
      need further confirmation with SpDSA.
CI  - Copyright (c) 2014. Published by Elsevier Inc.
FAU - Cao, Wenjie
AU  - Cao W
AD  - Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
FAU - Huang, Lei
AU  - Huang L
AD  - Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
FAU - Ge, Liang
AU  - Ge L
AD  - Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
FAU - Lu, Gang
AU  - Lu G
AD  - Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
FAU - Zhang, Xiaolong
AU  - Zhang X
AD  - Department of Radiology, Huashan Hospital, Fudan University, Shanghai, China.
FAU - Dong, Qiang
AU  - Dong Q
AD  - Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China. 
      Electronic address: qdong@shmu.edu.cn.
LA  - eng
PT  - Journal Article
DEP - 20140806
PL  - United States
TA  - J Stroke Cerebrovasc Dis
JT  - Journal of stroke and cerebrovascular diseases : the official journal of National 
      Stroke Association
JID - 9111633
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Angiography, Digital Subtraction/*methods/standards
MH  - Central Nervous System Vascular Malformations/*diagnosis/*pathology
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - *Magnetic Resonance Imaging
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Spinal Cord/*blood supply
MH  - Spinal Cord Diseases/*pathology
OTO - NOTNLM
OT  - MRI
OT  - SDAVF
OT  - clinical characteristics
OT  - spinal angiography
EDAT- 2014/08/12 06:00
MHDA- 2015/11/18 06:00
CRDT- 2014/08/10 06:00
PHST- 2013/12/19 00:00 [received]
PHST- 2014/01/17 00:00 [revised]
PHST- 2014/01/30 00:00 [accepted]
PHST- 2014/08/10 06:00 [entrez]
PHST- 2014/08/12 06:00 [pubmed]
PHST- 2015/11/18 06:00 [medline]
AID - S1052-3057(14)00052-4 [pii]
AID - 10.1016/j.jstrokecerebrovasdis.2014.01.021 [doi]
PST - ppublish
SO  - J Stroke Cerebrovasc Dis. 2014 Sep;23(8):1995-2000. doi: 
      10.1016/j.jstrokecerebrovasdis.2014.01.021. Epub 2014 Aug 6.