The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas: the Toronto experienceLindenholz, A., TerBrugge, K. G., van Dijk, J. M. C. & Farb, R. I., Nov-2014, In : European Radiology. 24, 11, p. 2885-2894 10 p.
Research output: Contribution to journal › Article › Academic › peer-review
The purpose of this study was to determine the accuracy and utility of contrast-enhanced MR angiography (CE-MRA) in spinal dural arteriovenous fistulas (SDAVF).
A retrospective analysis from 1999-2012 identified 70 patients clinically suspected of harboring a SDAVF. Each patient underwent consecutive conventional MR-imaging, CE-MRA, and digital subtraction angiography (DSA). The presence or absence of serpentine flow voids, T2-weighted hyperintensity, and cord enhancement were evaluated, as well as location of the fistula as predicted by CE-MRA. DSA was used as the reference standard.
Of the 70 cases, 53 were determined to be a SDAVF, 10 cases were shown to be other forms of vascular malformation, and 7 were DSA-negative. On MRI, all reported cases of SDAVF showed serpentine flow voids (100 %). T2-weighted hyperintensity was seen in 48 of 50 cases (96 %), extending to the conus in 41 of 48 cases (85 %). Cord enhancement was seen in 38 of 41 cases (93 %). CE-MRA correctly localized the SDAVF in 43 of the 53 cases (81 %).
CE-MRA is a useful non-invasive examination for the detection and localization of SDAVF. CE-MRA facilitates but does not replace DSA as confirmation of location, fistula type, and arterial detail, which are required before treatment.
aEuro cent CE-MRA correctly localized the site of the SDAVF in over 80 % of cases.
aEuro cent CE-MRA facilitates diagnostic DSA and expedites the diagnostic process.
aEuro cent CE-MRA does not replace diagnostic DSA in SDAVF cases as confirmative test.
aEuro cent CE-MRA provides better understanding of missed or mislocalized SDAVF cases.
|Number of pages||10|
|Publication status||Published - Nov-2014|
- Spinal dural arterial venous fistula, Localization, Contrast-enhanced MRA, MR imaging, DSA examination, COMPUTED-TOMOGRAPHY, VASCULAR-DISEASE, MALFORMATIONS, PHASE