Vercelli GG, Venturi F, Minardi M, Cofano F, Zenga F, Bergui M, Garbossa D. Time-Resolved Magnetic Resonance Angiography for Follow-Up of Treated Dural and Epidural Spinal Arteriovenous Fistula.
J Neurol Surg A Cent Eur Neurosurg 2021;
83:561-567. [PMID:
34911087 DOI:
10.1055/s-0041-1739205]
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Abstract
BACKGROUND
Spinal arteriovenous fistulas (AVFs) are uncommon vascular malformations of spinal dural and epidural vessels. Actually digital subtraction angiography (DSA) is the gold standard for diagnosis and follow-up. The aim of this study is to demonstrate the validity of the multiphasic magnetic resonance angiography (MRA) to identify recurrent/residual AVFs or their correct surgical and/or endovascular closure.
METHODS
A retrospective cases series with perimedullary venous plexus congestion due to spinal dural or epidural AVF was performed at our center from April 2014 to September 2019. After 1 month from treatment, the patients were subjected to time-resolved MRA and DSA to demonstrate recurrence or correct closure of AVFs.
RESULTS
We collected a series of 26 matched time-resolved MRA and DSA in 20 patients who underwent an endovascular and/or surgical procedure. In our series, we reported five cases of recurrence. Time-resolved MRA detected six cases of recurrence, with 100% sensitivity and 95% specificity (p < 0.001). We used DSA as the standard reference.
CONCLUSION
Time-resolved MRA is a valid tool in posttreatment follow-up to detect recurrent or residual AVFs. It has high sensitivity and specificity and may replace DSA.
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