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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 28:1271-1279, August 2007
DOI 10.3174/ajnr.A0541
© 2007 American Society of Neuroradiology

SPINE

MR Diffusion Tensor Imaging and Fiber Tracking in Spinal Cord Arteriovenous Malformations: A Preliminary Study

A. Ozanne^a, T. Krings^a, D. Facon^a, P. Fillard^b, J.L. Dumas^c, H. Alvarez^a, D. Ducreux^a and P. Lasjaunias^a

^a Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital de Bicêtre, Le Kremlin-Bicêtre, Paris, France
^b Department of Computer Science, University of North Carolina, Chapel Hill, NC
^c Department of Radiology, Hôpital Avicenne, Université Paris, Bobigny, France

Please address correspondence to Augustin Ozanne, Service de Neuroradiologie Diagnostique et Thérapeutique, Hôpital de Bicetre, 78 rue du General-Leclerc, 94275 Le Kremlin-Bicêtre, Paris, France; e-mail: augustin.ozanne{at}bct.ap-hop-paris.fr

BACKGROUND AND PURPOSE: Diffusion tensor imaging (DTI) of the spinal cord in patients harboring spinal arteriovenous malformations (AVMs) was carried out to evaluate the feasibility of this new technique to determine the displacement of the spinal cord tracts and to correlate morphologic and functional DTI data (fractional anisotropy [FA] and apparent diffusion coefficient [ADC]) with the clinical symptoms.

MATERIALS AND METHODS: Nine patients with spinal cord AVMs were investigated at 1.5T using a sagittal spin-echo single-shot echo-planar generalized autocalibrating partially parallel acquisition diffusion-weighted imaging sequence. ADC and FA maps were computed in different regions of interest (both above and below the nidus), and tractography was used to visualize the course of the tracts. The data were correlated with the clinical symptoms and compared with 12 healthy control subjects.

RESULTS: At the level of the nidus, tracts were normal, shifted, separated, or interrupted but not intermingled with the nidus. Interruption of the tracts was coherent with the clinical symptoms. In patients with severe neurologic deficits, FA values caudal to the nidus showed a reduced anisotropy consistent with loss of white matter tracts.

CONCLUSIONS: We demonstrate that AVMs may interrupt, displace, or separate the fiber tracts and that clinical symptoms may be reflected by the quantitative FA results and the morphologic loss of fibers distant to the lesion. DTI with fiber tracking offers a novel approach to image spinal cord AVMs and may open a window to understand the complex pathophysiology of these lesions.

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