| Accuracy and pitfalls of multidetector-row computed tomography in detecting spinal dural arteriovenous fistulas. | |
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MedLine Citation:
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PMID: 20192621 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECT: The purpose of this study was to evaluate the accuracy of multidetector-row CT angiography (MDCTA) in demonstrating spinal dural arteriovenous fistulas (SDAVFs). METHODS: The authors studied 10 patients with SDAVFs, including 2 with spinal epidural AVFs, who underwent preoperative MR imaging, MDCTA, and digital subtraction angiography (DSA). In the evaluation of coronal sections of multiplanar reformation MDCTA images, inspection was focused on the presence of the following findings: 1) dilated perimedullary veins in the spinal canal; 2) focal enhancement of the nerve root, suggesting the location of the AVF, around the dural sleeve; and 3) a radicular vein that drains the AVF into perimedullary veins. The utility of MDCTA was assessed by comparing its findings with those of DSA in each case. RESULTS: Digital subtraction angiography confirmed that the AVFs were located in the thoracic spine in 4 patients and in the lumbar spine in 6 patients, and MDCTA detected dilated perimedullary veins in all 10 patients. In 8 patients, there was focal enhancement of the nerve root. The radicular vein that drains the AVF into the perimedullary veins was found in 8 cases. In 8 cases, the MDCTA-derived level and side of the AVF and its feeder corresponded with those shown by DSA. In 2 patients, however, the MDCTA-derived side of the feeder was on the side contralateral to the feeding artery confirmed by DSA. These lesions were interpreted as spinal epidural AVFs with perimedullary drainage. In 2 cases, MDCTA could not detect the multiplicity of their feeders. CONCLUSIONS: The use of MDCTA preceding DSA can be helpful to focus the selective catheter angiography on certain spinal levels. However, one should keep in mind that epidural AVFs with perimedullary drainage may resemble SDAVFs and also that MDCTA cannot exclude the possibility of multiple feeders. Further research should elucidate how broadly selective angiography should explore around the MDCTA-suggested target. |
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Authors:
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Satoshi Yamaguchi; Tetsuya Nagayama; Kuniki Eguchi; Masaaki Takeda; Kazunori Arita; Kaoru Kurisu |
Publication Detail:
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Type: Case Reports; Evaluation Studies; Journal Article |
Journal Detail:
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Title: Journal of neurosurgery. Spine Volume: 12 ISSN: 1547-5646 ISO Abbreviation: J Neurosurg Spine Publication Date: 2010 Mar |
Date Detail:
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Created Date: 2010-03-02 Completed Date: 2010-04-05 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101223545 Medline TA: J Neurosurg Spine Country: United States |
Other Details:
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Languages: eng Pagination: 243-8 Citation Subset: IM |
Affiliation:
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Department of Neurosurgery, Hiroshima University Graduate School of Biomedical Sciences, Minami-ku, Hiroshima, Japan. satjp02@yahoo.co.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angiography / methods* Angiography, Digital Subtraction Central Nervous System Vascular Malformations / pathology, radiography*, surgery Female Follow-Up Studies Humans Lumbar Vertebrae Magnetic Resonance Imaging Male Middle Aged Retrospective Studies Spinal Cord / pathology, radiography*, surgery Thoracic Vertebrae Tomography, X-Ray Computed / methods* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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