Table 1.
Summary of patients and findings of contrast enhanced MR angiography and DSA.
Fig 1.
A 53-year-old man with spinal dural arteriovenous fistula (DAVF) (patient 1).
T2-weighted sagittal image (A) revealing tortuously dilated perimedullary veins in the thoracic and lumbar spinal canal. Serial maximum intensity projection (MIP) images of low-dose time-resolved contrast-enhanced magnetic resonance angiography (CE-MRA) (B) revealing sequential visualization of dilated perimedullary veins from the top of the field-of-view. MIP images of the entire field of view (C) and coronal segmental MIP image (D) of three-dimensional single-phase high-resolution CE-MRA revealed fistula at the left T6 level. Spinal digital subtraction angiography (E) confirmed spinal DAVF with shunt located at the matched level.
Fig 2.
A 33-year-old man with perimedullary arteriovenous fistula (pmAVF) (patient 6).
Sequential MIP images of low-dose TR CE-MRA showed early visualization of dilated venous sac (arrow) and perimedullary venous drainage (A). In addition, there were hypoplastic both 1st lumbar arteries, which were confirmed on subsequent DSA (not shown). MIP and segmented axial MIP images of single-phase HR CE-MRA (B) showed spinal AVM with feeding artery of anterior spinal artery from prominent radicular artery at left L3 level. Spinal DSA (C) confirmed spinal AVM with anterior spinal artery arising at the matched level. Follow up low-dose TR CE-MRA (D) obtained 7 days after surgery revealed obliteration of previously noted dilated venous sac. MIP and segmented axial MIP images of follow up single-phase HR CE-MRA (E) also showed obliteration of dilated venous sac, yet with still prominent radicular artery at left L3 level and several perimedullary vessels. Delayed contrast enhanced T1 weighted MR image (F) also showed contrast enhancement at the perimedullary vessels.
Fig 3.
A 31-year-old man with spinal arteriovenous malformation (AVM) (patient 5).
Sagittal T2-weighted image (A) revealed tortuous vascular signal voids. Serial maximum intensity projection (MIP) images of low-dose time-resolved contrast-enhanced magnetic resonance angiography (CE-MRA) (B) revealed early visualization of a dilated venous sac. Volume-rendering reconstruction image (C) and segmental MIP images (D) of single-phase high-resolution CE-MRA revealed arterial feeders of the shunt, including the anterior spinal artery arising from the left T9 intercostal artery and posterior spinal arteries from both T9 intercostal arteries. Spinal digital subtraction angiography (E) confirmed spinal AVM with matched level of feeding arteries.
Table 2.
Combined low-dose time-resolved and single-phase high-resolution contrast-enhanced MR angiography for the diagnosis of spinal vascular diseases.
Table 3.
Combined low-dose time-resolved and single-phase high-resolution contrast-enhanced MR angiography for the initial characterization of spinal vascular disease.
Table 4.
Magnetic resonance angiography sequences and contrast media for the evaluation of a spinal vascular disease in the present series and previous reports.