Peripheral Spinal Cord Hypointensity on T2-weighted MR Images: A Reliable Imaging Sign of Venous Hypertensive Myelopathy

Fig 2. A, Anteroposterior view of spinal angiogram shows early filling of pial venous drainage (arrowheads) from spinal DAVF (arrow indicates catheter tip).

B, Sagittal FSE T2-weighted (5600/100_eff) MR image shows enlarged pial vessels, central increased cord signal, and rim of peripheral hypointensity (arrowheads).

Fig 3. A, Anteroposterior subtracted view of early arterial-phase injection of the left hypogastric artery shows dural AVF (arrow) with sacral feeding vessels. Arrowheads signify draining veins.

B, Sagittal contrast-enhanced T1-weighted (400/14) MR image shows intraparenchymal cord enhancement as well as enhancement of enlarged vessels on the cord surface.

C, Sagittal FSE T2-weighted (4400/100_eff) image shows multiple flow voids on the cord surface, increased signal intensity within the central cord, as well as a rim of peripheral hypointensity (arrowheads).

Fig 4. A and B, Late arterial-phase anteroposterior (A) and lateral (B) right vertebral artery injection shows filling of dural arteriovenous fistula (open arrow, B) originating from intradural vertebral artery. Drainage along cervical spinal cord is visible in both views (closed arrows).

C, Coronal contrast-enhanced MR image shows intraaxial cervicomedullary enhancement and enlarged pial cervical vein (arrowheads).

D and E, Sagittal (3733/100_eff) (D) and axial (4000/100_eff) (E) T2-weighted images of cervical cord show subpial hypointensity (arrowheads).