Neuroradiology

, Volume 59, Issue 10, pp 997–1002 | Cite as

Diagnosis of spinal dural arteriovenous fistula using 3D T2-weighted imaging

  • Stephen F. Kralik
  • Daniel Murph
  • Peter Mehta
  • Darren P. O’Neill
Spinal Neuroradiology
  • 228 Downloads

Abstract

Purpose

To evaluate spinal MRIs without and with 3D T2W imaging among patients without and with spinal dural arteriovenous fistula (SDAVF) confirmed by spinal digital subtraction angiography (DSA).

Methods

A retrospective case-control study was performed among patients without and with SDAVF who had both spinal MRIs and gold standard spinal DSA. Two neuroradiologists independently reviewed spinal MRIs that were performed with either sagittal T2W turbo spin echo (2D group) or sagittal 3D T2W sampling perfection with application-optimized contrasts using different flip-angle evolutions (SPACE) (3D group) and documented the presence or absence of SDAVF. Using spinal DSA diagnosis as a gold standard, the sensitivity, specificity, and interobserver agreement for the 2D-group and 3D-group MRI diagnosis were calculated.

Results

The 2D group consisted of 21 patients and the 3D group consisted of 16 patients. For both radiologists, the 2D group demonstrated a sensitivity of 100% and specificity of 100%. Interobserver agreement in the 2D group was perfect (k = 1.0). For both radiologists, the 3D group demonstrated sensitivity of 100.0% and specificity of 92.3%. Interobserver agreement in the 3D group was perfect (k = 1.0). While flow voids were considered more conspicuous, spinal cord signal abnormality was considered less conspicuous with 3D T2W SPACE compared with conventional 2D STIR sequence.

Conclusion

3D T2W SPACE should be used in conjunction with 2D T2W sequences to more accurately detect abnormal cord signal and determine when perimedullary flow voids are pathologically abnormal for the radiologic diagnosis of SDAVF.

Keywords

Arteriovenous fistula MRI Spine Myelopathy Angiography 

Abbreviations

SDAVF

Spinal dural arteriovenous fistula

DSA

Digital subtraction angiography

SPACE

Sampling perfection with application-optimized contrasts using different flip-angle evolutions

CISS

Constructive interference in steady state

FIESTA

Fast imaging employing steady-state acquisition

Notes

Compliance with ethical standards

Funding

No funding was received for this study.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required.

Informed consent

For this type of retrospective study formal consent is not required.

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Stephen F. Kralik
    • 1
  • Daniel Murph
    • 1
  • Peter Mehta
    • 1
  • Darren P. O’Neill
    • 1
  1. 1.Department of Radiology and Imaging SciencesIndiana University School of MedicineIndianapolisUSA

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