MR Selective Flow-Tracking Cartography: A Postprocessing Procedure Applied to Four-dimensional Flow MR Imaging for Complete Characterization of Cranial Dural Arteriovenous Fistulas

Although more prevalent in males in the 6th and 7th decade of life, spinal dural arteriovenous fistulas (SDAVFs) are an uncommon cause of progressive myelopathy. Magnetic resonance imaging and more recently Gd bolus MR angiography have been used to diagnose, radiographically define, and preprocedurally localize the contributing lumbar artery. Three-dimensional myelographic MR imaging sequences have recently been developed for anatomical evaluation of the spinal canal. The authors describe 3 recent cases in which volumetric myelographic MR imaging with a 3D phase-cycled fast imaging employing steady state acquisition (PC-FIESTA) and a 3D constructive interference steady state (CISS) technique were particularly useful not only for documenting an SDAVF, but also for providing localization when CT angiography, MR imaging, MR angiography, and spinal angiography failed to localize the fistula. In a patient harboring an SDAVF at T-4, surgical exploration was performed based on the constellation of findings on the PC-FIESTA images as well as the fact that the spinal segments leading to T-4 were the only ones that the authors were unable to catheterize. In a second patient, who harbored an SDAVF at T-6, after 2 separate angiograms failed to demonstrate the fistula, careful assessment of the CISS images led the authors to focus a third angiogram on the left T-6 intercostal artery and to perform superselective microcatheterization. In a third patient with an SDAVF originating from the lateral sacral branch, the PC-FIESTA sequence demonstrated the arterialized vein extending into the S-1 foramen, leading to a second angiogram and superselective internal iliac injections. The authors concluded that myelographic MR imaging sequences can be useful not only as an aid to diagnosis but also for localization of an SDAVF in complex cases.

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The application of susceptibility-weighted MRI in pre-interventional evaluation of intracranial dural arteriovenous fistulas

Journal of NeuroInterventional Surgery ◽

10.1136/neurintsurg-2016-012314 ◽

2016 ◽

Vol 9 (5) ◽

pp. 502-507 ◽

Cited By ~ 1

Author(s):

Narendra Kumar Jain ◽

Santhosh Kumar Kannath ◽

Tirur Raman Kapilamoorthy ◽

Bejoy Thomas

Keyword(s):

Clinical Symptoms ◽

Therapeutic Assessment ◽

Arteriovenous Fistulas ◽

Non Invasive ◽

Conventional Mri ◽

Dural Arteriovenous Fistulas ◽

Cortical Venous Reflux ◽

Venous Ectasia ◽

High Degree

Background and purposeDetection and characterization of intracranial dural arteriovenous fistula (DAVF) is important to plan appropriate therapeutic management. The aim of this study was to analyze the utility of susceptibility-weighted MRI (SWI) in the pre-therapeutic assessment of DAVF in comparison with gold standard digital subtraction angiography (DSA).Materials and methodsProspectively, 26 patients with DAVFs underwent a thorough clinical examination and MRI including SWI followed by cerebral DSA. Two observers blinded to the DSA findings evaluated conventional MRI and SWI images and identified the fistulous area (FA), cortical venous reflux (CVR), and cortical venous ectasia (CVE) and compared these observations with the DSA findings documented by a third observer.ResultsAggressive clinical symptoms were observed in 31% of patients and benign features were noted in 69% of DAVFs. Conventional MRI could identify the FA in only 27% of patients. SWI accurately located 75% of all the FAs in 23 patients. However, SWI failed to identify DAVFs in three patients. CVR was detected in 89.6% of all aggressive DAVFs. The accuracy of SWI to identify CVE was 100% and the extent and degree correlated with DSA observations.ConclusionsSWI is a reliable non-invasive tool for the localization and characterization of DAVFs and is superior to conventional MRI in the evaluation of DAVFs. This sequence can demonstrate underlying cerebral hemodynamic stresses with a high degree of accuracy and provide valuable pre-therapeutic information.

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Arterial spin labeling MR imaging aids to identify cortical venous drainage of dural arteriovenous fistulas

Medicine ◽

10.1097/md.0000000000010697 ◽

2018 ◽

Vol 97 (19) ◽

pp. e0697 ◽

Cited By ~ 2

Author(s):

Ji Hee Kang ◽

Tae Jin Yun ◽

Jong Kook Rhim ◽

Young Dae Cho ◽

Dong Hyun Yoo ◽

...

Keyword(s):

Mr Imaging ◽

Arterial Spin Labeling ◽

Venous Drainage ◽

Spin Labeling ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Cortical Venous Drainage

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Surgical and endovascular treatment of spinal dural arteriovenous fistulas: long-term disability assessment and prognostic factors

Journal of Neurosurgery Spine ◽

10.3171/spi.2001.94.2.0199 ◽

2001 ◽

Vol 94 (2) ◽

pp. 199-204 ◽

Cited By ~ 22

Author(s):

Joon K. Song ◽

Fernando Viñuela ◽

Y. Pierre Gobin ◽

Gary R. Duckwiler ◽

Yuichi Murayama ◽

...

Keyword(s):

Prognostic Factors ◽

Mr Imaging ◽

Symptom Onset ◽

Disability Score ◽

Content Type ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Spinal Dural Arteriovenous Fistulas ◽

Fine Print

Object. The authors assessed clinical outcomes of patients with treated spinal dural arteriovenous fistulas (DAVFs) and investigated prognostic factors. Methods. Thirty consecutive patients with spinal DAVFs were treated at the authors' institution during the past 15 years: seven underwent surgery; seven underwent surgery after failed embolization; and 16 underwent embolization alone. The outcomes of gait and micturition disability were analyzed. Follow up averaged 3.4 years (range 1 month–11.8 years). Age, duration of symptoms, pre- and postintervention magnetic resonance (MR) imaging findings, and preintervention disability were correlated with outcome. Seventeen patients (57%) experienced improved gait, 12 (40%) were unchanged, and one (3%) was worse. In 11 patients (37%) micturition function was improved, in 15 (50%) it was unchanged, and in four (13%) it was worse. Gait disability, as measured by the Aminoff—Logue Scale, was significantly improved after treatment, from 3.4 ± 1.4 (average ± standard deviation) to 2.7 ± 1.5 (p = 0.007). Mean micturition disability scores decreased, but not significantly, from 1.9 ± 1 to 1.6 ± 1.1 (p = 0.20). Preintervention gait disability was not associated with improvement except for patients with Aminoff—Logue Scale Grade 4 disability (eight of nine improved; p = 0.024). For patients treated within 13 months of symptom onset, mean micturition disability decreased (p = 0.035). No association was found between clinical improvement and age, a symptom duration less than 30 months, or pre- and postintervention MR imaging—documented spinal cord edema. Conclusions. Spinal DAVF treatment significantly improved patients' mean gait disability score by almost one grade at last follow up. The mean micturition disability score was not significantly improved, unless treatment was performed within 13 months of symptom onset. Longer and more uniform follow-up study is needed to determine if improved and stabilized clinical outcomes are sustained.

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Gadolinium-DTPA Enhanced MR Imaging of Spinal Dural Arteriovenous Fistulas

Journal of Computer Assisted Tomography ◽

10.1097/00004728-198901000-00006 ◽

1989 ◽

Vol 13 (1) ◽

pp. 30-37 ◽

Cited By ~ 61

Author(s):

Burckhard Terwey ◽

Hartmut Becker ◽

Armin K. Thron ◽

Georg Vahldiek

Keyword(s):

Mr Imaging ◽

Gadolinium Dtpa ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas ◽

Spinal Dural Arteriovenous Fistulas

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MR IMAGING AND MR ANGIOGRAPHY IN THE DIAGNOSIS OF DURAL ARTERIOVENOUS FISTULAS

Magnetic Resonance Imaging Clinics of North America ◽

10.1016/s1064-9689(21)00259-2 ◽

1995 ◽

Vol 3 (3) ◽

pp. 493-508

Author(s):

David J. Panasci ◽

Peter K. Nelson

Keyword(s):

Mr Imaging ◽

Mr Angiography ◽

Arteriovenous Fistulas ◽

Dural Arteriovenous Fistulas

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Beware of the Brain Stem:Craniocervical Dural Arteriovenous Fistulas. Case Series and Literature Review

Neurographics ◽

10.3174/ng.1800064 ◽

2019 ◽

Vol 9 (6) ◽

pp. 349-357

Author(s):

M.A. McDonald ◽

S.E. Olson ◽

P. Abraham ◽

J. Handwerker

Keyword(s):

Literature Review ◽

Mr Imaging ◽

Case Series ◽

Imaging Findings ◽

Arteriovenous Fistulas ◽

Timely Diagnosis ◽

Clinical Presentations ◽

Wide Range ◽

Dural Arteriovenous Fistulas ◽

The Brain

Craniocervical dural arteriovenous fistulas are rare but clinically important entities that are potentially treatable but often misdiagnosed given their wide range of clinical presentations and often nonspecific findings on CT and MR imaging. Although DSA remains the criterion standard for diagnosis, the present case series highlights imaging findings of craniocervical dural arteriovenous fistulas and potential mimics to aid the practicing radiologist in a timely diagnosis.

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