The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas: the Toronto experience

Lindenholz, A., TerBrugge, K. G., van Dijk, J. M. C. & Farb, R. I., Nov-2014, In : European Radiology. 24, 11, p. 2885-2894 10 p.

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  • The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas

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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.

Original languageEnglish
Pages (from-to)2885-2894
Number of pages10
JournalEuropean Radiology
Issue number11
Publication statusPublished - Nov-2014


  • Spinal dural arterial venous fistula, Localization, Contrast-enhanced MRA, MR imaging, DSA examination, COMPUTED-TOMOGRAPHY, VASCULAR-DISEASE, MALFORMATIONS, PHASE

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