Ten patients with spinal arteriovenous malformations avms were examined with highfieldstrength 1. Diagnostic imaging of intracranial vascular malformations 1. In surgery for arteriovenous malformation avm and dural arteriovenous fistula. Spinal arteriovenous malformations can be classified in a number of ways. Embolization is a minimallyinvasive technique for blocking the abnormal vessels in an arteriovenous malformation or dural fistula. Dynamic assessment of venous anatomy and function in. Magnetic resonance angiography in the diagnosis of cerebral. Dural arteriovenous fistulas davf are a heterogeneous collection of conditions that share arteriovenous shunts from dural vessels. Superficial avms may be supplied from the external carotid artery with a dural component. Most dural arteriovenous fistulas present in adulthood and account for 1015% of all cerebral vascular malformations 6. It is a tangle of abnormal blood vessels arteries and veins. Mr visualization of spinal dural arteriovenous fistula. The use of 4dcta in the diagnostic workup of brain. Monitoring treatment effectiveness in intracranial.
They present variably with hemorrhage or venous hypertension and can be challenging to treat. Detection of spinal dural arteriovenous fistulae with mr. Physical examination suggested probable positive neck resistance. Imaging of cerebral avm and arteriovenous fistulas and. A dural avm is an arteriovenous malformation that occurs in the coverings of the brain the dura hence the name dural avm. The microscope was also integrated into the neuronavigation software as a pointer blue crosshair in fig. Their classification depends on the differentiation of shunting versus. We report on a 56yearold male patient with progressive neurological symptoms. Background the angioarchitectural features of an arteriovenous malformation avm provide key information regarding natural history and treatment planning. In this study, we sought to identify mr imaging finding differences between davf types classified on the basis of venous drainage patterns. Dural arteriovenous fistula is thought to be an acquired or developmental anomaly responsible for about 1015% of all intracranial vascular malformations 1, 2. Vascular malformations arteriovenous malformations and.
Impact of microscopeintegrated intraoperative near. An arteriovenous malformation is a tangled cluster of vessels, typically located in the supratentorial part of the brain, in which arteries connect directly to veins without any. Arteriovenous malformations and dural arteriovenous fistulas ghaus m. Davfs account for 10%15% of intracranial arteriovenous malformations.
The level and side of the suspected spinal dural arteriovenous fistula sdavf and the feeding arteries in spinal arteriovenous malformations savms were. Spinal dural arteriovenous fistulas sdavf account for about 70% of all spinal av shunts. Timeresolved 3ddsa 4ddsa enables viewing vasculature from any desired angle and time frame. Dural arteriovenous fistula dural avf mri a 28 y o female with right orbital proptosis and congestion. Duralpial arteriovenous malformation after sinus thrombosis stroke. Dural av fistulaimaging angiography best imaging tool dsa with superselective catheterization of dural and transosseous feeders. Dsa is the standard for determining avm obliteration, and it. Susceptibilityweighted imaging swi is a mri technique that combines phase and magnitude signal to produce highresolution images of the cerebral venous system. Spinal dural arteriovenous fistula sdavf is the most common spinal vascular malformation, however it is still rare and underdiagnosed. Arteriovenous malformations typically involve the brain, but occasionally, they are associated with the spinal cord and its dura. It was previously reported that intraoperative 3dimensional 3d fluoroscopy is suitable to image intracranial aneurysms. In patients with dural arteriovenous fistula, source images of 3d tof mr. Arterial spinlabeling asl is a completely noninvasive mr imaging technique.
Perfect imaging offers comprehensive diagnostic imaging center solutions that solve an array of problems for radiologists and radiology departments. Accuracy of fourdimensional ct angiography in detection and. Imaging of dural arteriovenous fistula researchgate. The avm was operated on using a suboccipital approach and a total of 4 icg investigations were performed. Dural arteriovenous fistulas diagnosis and treatment. Intracranial arteriovenous malformations sciencedirect. In an endovascular procedure, your doctor may insert a long, thin tube catheter into a blood vessel in your leg or groin and thread it through blood vessels to the dural arteriovenous fistula using xray imaging. Application of timeresolved 3d digital subtraction.
The initial icg videoangiography provided information on the avmassociated. Accuracy of fourdimensional ct angiography in detection and characterisation of arteriovenous malformations and dural arteriovenous fistulas. Patients with an avm which is also associated with arteriovenous. If you have the appropriate software installed, you can download article.
Spinal dural arteriovenous fistula presenting with. The software enabled enlargement of regions of interest in any 3d direction with. Intracranial davfs are pathologic shunts between dural arteries and dural venous sinuses, meningeal veins, or cortical veins. The radiological findings and investigation of patients presenting with aneurysmal subarachnoid haemorrhage sah, arteriovenous malformation avm, dural arteriovenous. Arteriovenous malformations avms are congenital lesions composed of a complex tangle of arteries and veins connected by one or more fistulae see the image below.
Imaging of cerebral arteriovenous malformations and. Your doctor inserts the catheter into the blood vessel that leads to the davf and releases coils or a glue. In addition, spinal digital subtraction angiography and spinal. Microscope cameras, microscope to camera adapters, microscopes, software, macro photography, stereo support stands, and complete imaging systems for pathology, bioresearch.
A dural davf or pial pavf arteriovenous fistula is an abnormal direct connection fistula between an artery. Dural arteriovenous malformations davm what is an avm and a davm. Dural arteriovenous fistula davf, also known as dural arteriovenous. Magnetic resonance imaging findings such as spinal cord edema and dilated and tortuous perimedullary veins play a pivotal role in the confirmation of the diagnosis. Dural arteriovenous fistula radiology reference article. Originally employed in cardiac imaging, the use of fourdimensional ct angiography 4dcta has evolved to encompass diagnosis of cerebral avms and dural arteriovenous av fistulas. The optimal imaging followup during this period is unknown, but mri is often performed at 6 to 12 mo intervals. Value and limitations of contrastenhanced mr angiography in. This page is intended as a source of information for patients suspected of or having been diagnosed with a spinal arteriovenous malformation, or spinal avm. This article describes the various types of subpial or dural avm and the specific characteristics. This article describes the various types of subpial or dural avm and. Ibm, armonk, new york and medcalc statistical software, version 17. The boneless image software inspace was used to reconstruct.
Imaging of cerebral arteriovenous malformations and dural. Dural arteriovenous fistulae davf constitute 1015% of all intracranial vascular malformations. Accuracy of fourdimensional ct angiography in detection. Some avms with a high risk of bleeding or those that are difficult to access via angiography catheters may require surgical removal.
Four avms were intramedullary, and six were extramedullary. Pacs system imaging center solutions perfect imaging. Vascular malformations of the spine and spinal cord. Spinal avm classification radiology reference article. Brain magnetic resonance imaging and cerebral angiography revealed a small, spetzlermartin grade 2 left parietal arteriovenous malformation avm, fed by branches of the left mca and. They should be identified on ct scan and mri before resorting to angiography. The use of 4dcta in the diagnostic workup of brain arteriovenous malformations.
Diagnostic imaging of intracranial vascular malformations. It is usually done in an attempt to eliminate or reduce the risks of hemorrhage associated with either an avm or davf. Sensitivity, specificity, and prediction of vertebral level efrat saraflavi, brian c. Cerebral arteriovenous malformations submitted by anthony chang, md. Vascular malformations arteriovenous malformations and dural arteriovenous fistulas. Venous drainage patterns are a major determinant of clinical outcome in intracranial dural arteriovenous fistula davf patients. Accuracy of susceptibilityweighted imaging for the. Mr imaging findings of intracranial dural arteriovenous. Current theory in imaging of intracranial vascular disease.
Fifty patients 66% males and 34% females with cerebral arteriovenous malformations and dural arteriovenous fistulas. Imaging plays a major role in the identification, grading, and treatment of cerebral arteriovenous malformations and cerebral dural arteriovenous fistulas. This series was performed to assess if cerebral arteriovenous malformations avm and dural arteriovenous fistulae davf can be detected at appropriated quality by intraoperative 3d. Spinal vascular malformations are rare diseases with a wide variety of neurologic presentations. Detection of spinal dural arteriovenous fistulae with mr imaging and contrastenhanced mr angiography.
90 991 917 946 546 630 282 1485 748 1183 1031 1571 1184 528 1514 999 1009 1645 1535 670 492 1439 473 262 40 100 1281 295 652 594