This study was to evaluate the value of four-dimensional computed tomography 
angiography (4D-CTA) in the diagnosis of intracranial dural arteriovenous 
fistula (DAVF). This study included 16 patients who were diagnosed to have 
intracranial DAVF by digital subtraction angiography (DSA). The 4D-CTA was 
performed by Aquilion ONE multi-detector CT scanner (Toshiba Medical Systems, 
Japan) equipped with 320 × 0.5 mm detector rows. Standard biplane fluoroscopy 
equipments (Infinix, Toshiba Medical Systems, Japan and ADVANTX LC/LP, GE 
Medical Systems, Milwaukee, WI, USA) were applied in the diagnosis of 
intra-arterial DSA. Examinations were performed to evaluate the findings of DSA 
and 4D-CTA in each patient. The examination results were read by two independent 
readers in a blind manner. All results were documented on standardized scoring 
sheets. In all 16 cases, the same diagnosis results of intracranial DAVF were 
obtained from DSA and 4D-CTA. The results of subtype (Borden and Cognard 
classification), venous reflux and fistula sites were also accurately exhibited 
in 4D-CTA. In addition, there was a little discrepancy in identifying smaller 
and specific arterial branches and in distinguishing fistula type (focal or 
diffuse) using 4D-CTA. Good-to-excellent agreements were made between 4D-CTA and 
DSA. Therefore, 4D-CTA could be a feasible tool for the characterization of 
intracranial DAVF, with respect to determining fistula site and venous drainage.