RT Journal Article
SR Electronic
T1 Preangiographic Evaluation of Spinal Dural Arteriovenous Fistulas with Elliptic Centric Contrast-Enhanced MR Angiography and Effect on Radiation Dose and Volume of Iodinated Contrast Material
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 711
OP 718
VO 26
IS 4
A1 Patrick H. Luetmer
A1 John I. Lane
A1 Julie R. Gilbertson
A1 Matt A. Bernstein
A1 John Huston III
A1 John L. D. Atkinson
YR 2005
UL http://www.ajnr.org/content/26/4/711.abstract
AB BACKGROUND AND PURPOSE: The detection and localization of spinal dural arteriovenous fistulas (AVFs) remain diagnostic challenges. This study tested the hypothesis that elliptic centric contrast-enhanced MR angiography (MRA) can be used to detect spinal dural AVFs, predict the level of fistulas, and reduce the radiation dose and volume of iodinated contrast material associated with conventional angiography.METHODS: We examined 31 patients who presented with suspected spinal dural AVF between December 2000 and March 2004. All patients underwent MRA and conventional angiography. The effect of MRA on subsequent conventional angiography was assessed by analyzing total fluoroscopy time and volume of iodinated contrast material used.RESULTS: At angiography, spinal dural AVFs were diagnosed in 22 of 31 patients, and MRA depicted an AVF in 20 of the 22 patients. MRA findings correctly predicted a negative angiogram in seven of nine cases. Of the 20 true-positive MRA results, the level of the fistula was included in the imaging volume in 14. In 13 of these 14 cases, MRA results correctly predicted the side and the level of the fistula to within one vertebral level. Fluoroscopy time and the volume of contrast agent was reduced by more than 50% in the 13 patients with a spinal dural AVF in whom MRA prospectively indicated the correct level.CONCLUSION: Contrast-enhanced MRA can be used to detect spinal dural AVFs, predict the level of fistulas, and substantially reduce the radiation dose and volume of contrast agent associated with catheter spinal angiography.