Arteriovenous Fistulas (AVFs) Diagnosis in Children

Arteriovenous fistulas (AVFs) are diagnosed by noninvasive imaging of the brain to determine their location. Usually, diagnosis begins with one of the following imaging studies:

  • CT angiography (CTA): This test uses the technology of a conventional CT scan and a special dye (known as contrast) injected into a vein to generate images of the blood vessels. During CTA, the child must lie still on a table that slides slowly through a donut-shaped device (young children may need sedation to keep them still). A computer then constructs 3D images of the blood vessels from the CTA images.
  • Magnetic resonance angiography (MRA): These scans, based on MRI technology, generate images of the blood vessels, usually without the need to inject a contrast dye. They also avoid the use of x-rays.

Sometimes a catheter angiogram (also known as a cerebral angiogram or cerebral arteriogram) is needed. This test uses live x-rays to produce detailed images of the arteries and veins. A small needle is inserted into an artery in the groin, and a catheter (a thin, flexible tube) is guided to the area being studied. A special dye, injected through the catheter, allows the radiologist to more clearly see the AVF and the pattern of arteries and veins surrounding it. This test is usually done under general anesthesia. Read more about angiograms.

The treatment team at the Cerebrovascular Surgery and Interventions Center will provide advance instructions on how to prepare for these tests.

In addition to imaging tests, our neurologist colleagues may conduct a variety of specific tests to assess the child’s brain function. In addition, Boston Children’s often recommends that children with AVFs have blood testing for disorders that cause abnormalities of blood clotting, as these can increase their risk for AVF complications. Finally, we often recommend genetic screening for children with AVFs, as they may have a genetic mutation that can potentially cause other medical problems.