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J Neurol Surg A Cent Eur Neurosurg 2022; 83(06): 561-567
DOI: 10.1055/s-0041-1739205
Original Article

Time-Resolved Magnetic Resonance Angiography for Follow-Up of Treated Dural and Epidural Spinal Arteriovenous Fistula

Giovanni Giulio Vercelli
1   Department of Neurosurgery, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Piemonte, Italy
,
Fabrizio Venturi
2   Department of Neuroradiology, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Piemonte, Italy
,
Massimiliano Minardi
1   Department of Neurosurgery, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Piemonte, Italy
,
Fabio Cofano
3   Department of Neurosurgery, Universita degli Studi di Torino, Turin, Torino, Italy
,
Francesco Zenga
1   Department of Neurosurgery, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Piemonte, Italy
,
Mauro Bergui
2   Department of Neuroradiology, Azienda Ospedaliero Universitaria Citta della Salute e della Scienza di Torino, Torino, Piemonte, Italy
,
Diego Garbossa
4   Department of Neurosurgery, University of Turin, Turin, Italy
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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.

Keywords

arteriovenous fistula - spine vascular malformations - magnetic resonance angiography - multiphasic MRA - time resolved MRA


Publication History

Received: 08 July 2020

Accepted: 25 May 2021

Article published online:
15 December 2021

© 2021. Thieme. All rights reserved.

Georg Thieme Verlag KG
Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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