More articles from SPINE
- Clinical and Radiologic Characteristics of Deep Lumbosacral Dural Arteriovenous Fistulas
Twenty patients with deep lumbosacral spinal dural arteriovenous fistulas were included in this series. Cord T2 hyperintensity and contrast enhancement were present in most cases. The filum vein and/or lumbar veins were dilated in 95% of patients. Time-resolved contrast-enhanced dynamic MRA indicated a spinal DAVF at or below the L5 vertebral level in 7/8 (88%) patients who received time-resolved contrast-enhanced dynamic MRA before DSA. A bilateral arterial supply of the fistula was detected via DSA in 5 (25%) patients. The authors conclude that time-resolved contrast-enhanced dynamic MRA facilitates the detection of the drainage vein and helps to localize deep lumbosacral-located fistulas with a high sensitivity before DSA. Definite detection remains challenging and requires conventional spinal angiography.