Retrograde Cortical and Deep Venous Drainage in Patients with Intracranial Dural Arteriovenous Fistulas: Comparison of MR Imaging and Angiographic Findings
Mika Kitajimaa,
Toshinori Hiraia,
Yukunori Korogic,
Masayuki Yamuraa,
Koichi Kawanakaa,
Ichiro Ikushimaa,
Yoshiko Hayashidaa,
Yasuyuki Yamashitaa and
Junichi Kuratsub
a Department of Radiology, Kumamoto University School of Medicine, Kumamoto, Japan
b Department of Neurosurgery, Kumamoto University School of Medicine, Kumamoto, Japan
c Department of Radiology, University of Occupational and Environmental Health, School of Medicine Kitakyushu, Japan
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FIG 1. Case 19. A 78-year-old woman with dAVF in the left CS.
A, Lateral intra-arterial DSA of the left ECA shows the arteriovenous shunt in the left CS (long arrow) and retrograde venous drainage to the superior ophthalmic vein (short arrow) and cerebral cortical veins (arrowheads). Severity of the drainage was grade 2 (26%–50% of cortical veins on angiography).
B, Axial T2-weighted SE MR image shows flow voids (arrows) in the subarachnoid space, suggesting dilated cortical veins in bilateral frontal and parietal lobes.
C, Abnormal dilated cortical veins (arrows) are more prominent on this axial enhanced T1-weighted SE image than in B.
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FIG 2. Case 13. A 70-year-old woman with dAVF in the left CS. Enhanced 3D MP-RAGE image clearly shows marked dilatation and thrombus in the anterior part of the left superior ophthalmic vein (arrows).
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FIG 3. Case 17. A 50-year-old woman with dAVF in the left transverse sinus.
A, Lateral intra-arterial DSA of the left ECA shows obstruction of the left transverse sinus (arrows). Abnormal vessels (arrowheads) are observed around the obstructed left transverse sinus. Severity of the drainage was grade 2 (26%–50% of cortical veins on angiography).
B, Enhanced 3D MP-RAGE image shows abnormal dilated veins at the base of the cerebrum (arrow) and in the posterior fossa (arrowhead). Bilateral posterior cerebral arteries were identified on other sections (not shown).
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FIG 4. Case 4. A 62-year-old woman with dAVF in the left CS.
A, Lateral intra-arterial DSA of the left ICA shows retrograde venous drainage to the superior ophthalmic (arrow) and pontomedullary (arrowheads) veins.
B, Enhanced 3D MP RAGE image shows cephalocaudal, contiguous enhancing structures (arrow) at the ventral side of midbrain corresponding to retrograde venous drainage to the pontomedullary vein.
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FIG 5. Case 3. A 58-year-old woman with dAVF in the bilateral CSs. Enhanced 3D MP-RAGE image (and 3D FISP image, not shown) depicts a filling defect in the right inferior petrosal sinus (arrow). This finding suggests thrombosis in the right inferior petrosal sinus.
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