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AJNR - American Journal of Neuroradiology

A, Nonenhanced TOF MR venogram demonstrates reduced signal intensity within the right lateral sinus and occlusion of the right jugular bulb (arrow).

B, Single-frame MR-DSA image from the early arterial phase of the lateral acquisition demonstrates synchronous opacification of the intracranial ICA and right lateral sinus by an extensive DAVF.

C, Catheter angiogram confirms the diagnosis of a type IIa DAVF.

D, Most of the right lateral sinus has been packed with platinum coils.

E, Postembolization MR-DSA image (acquired as in B) reveals a modest residual shunt via branches of the occipital and posterior meningeal arteries.

F, Lateral MR-DSA frame demonstrates the regions of interest for measures of signal intensity: 1 indicates the ICA; 2, SSS; and 3, voG.

G and H, Preembolization (G) and postembolization (H) signal intensity–time plots. Plots in H demonstrate earlier (by 3 seconds) peak filling of the voG. 1 indicates the ICA; 2, SSS; and 3, voG. Vertical lines mark the peak intensities of the ICA and voG.

A, Axial nonenhanced T1-weighted MR image demonstrates marked distension of the left jugular bulb and sigmoid sinus caused by a thrombus (arrow).

B, Single MR-DSA frame from the early arterial phase of the lateral acquisition demonstrates synchronous opacification of the intracranial ICA and left transverse sinus caused by a DAVF fed primarily by branches of the left occipital and posterior auricular arteries.

C, Single MR-DSA frame from the midvenous phase of the frontal acquisition demonstrates enlarged arterial pedicles, occlusion of the left sigmoid sinus, and retrograde venous drainage into the right lateral sinus. Filling of the SSS is not delayed.

D, Single MR-DSA frame from the venous phase of the lateral acquisition demonstrates a large vein of Labbé (arrow) entering the left transverse sinus distal to the DAVF.