Utility of 3D SPACE T2-weighted volumetric sequence in the localization of spinal dural arteriovenous fistula

Santhosh Kumar Kannath Department of Imaging Sciences and Interventional Radiology, and

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Praveen Alampath Department of Imaging Sciences and Interventional Radiology, and

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Jayadevan Enakshy Rajan Department of Imaging Sciences and Interventional Radiology, and

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Bejoy Thomas Department of Imaging Sciences and Interventional Radiology, and

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P. Sankara Sarma Achutha Menon Centre for Health Science Studies, Sree Chitra Institute for Medical Sciences and Technology, Trivandrum, India

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Kapilamoorthy Tirur Raman Department of Imaging Sciences and Interventional Radiology, and

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OBJECTIVE

The aim of this study was to investigate the utility of a heavily T2-weighted volumetric MRI sequence (3D sampling perfection with application-optimized contrasts using different flip-angle evolutions [SPACE]) in the feeder localization of spinal dural arteriovenous fistula (SDAVF).

METHODS

Patients who were diagnosed with SDAVF and who had 3D SPACE source images available for review were identified from a retrospective review of medical records. A total of 16 patients were identified, and MR images were analyzed separately by 2 blinded observers. The accuracy of the observation and interobserver agreement were measured by Kendall's tau and kappa statistics.

RESULTS

The site of fistula was accurately predicted by Observers 1 and 2 in 81% and 88% of cases, respectively, which improved to 94% when the level was considered within 1 vertebral level. The observer agreement with gold-standard angiography and interobserver agreement were found to be highly significant (p < 0.0001).

CONCLUSIONS

The 3D SPACE MRI sequence is valuable in the precise detection of the site of SDAVF. It may help to tailor digital subtraction angiography and thereby reduce the radiation exposure, contrast load, and study time.

ABBREVIATIONS

CTA = CT angiography; DSA = digital subtraction angiography; FOV = field of view; MIP = minimal-intensity projection; MRA = MR angiography; SDAVF = spinal dural arteriovenous fistula; SPACE = sampling perfection with application-optimized contrasts using different flip-angle evolutions, T2W = T2-weighted.
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  • 1

    Ali S, , Cashen TA, , Carroll TJ, , McComb E, , Muzaffar M, & Shaibani A, et al.: Time-resolved spinal MR angiography: initial clinical experience in the evaluation of spinal arteriovenous shunts. AJNR Am J Neuroradiol 28:18061810, 2007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2

    Amarouche M, , Hart JL, , Siddiqui A, , Hampton T, & Walsh DC: Time-resolved contrast-enhanced MR angiography of spinal vascular malformations. AJNR Am J Neuroradiol 36:417422, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 3

    Baumert B, , Wörtler K, , Steffinger D, , Schmidt GP, , Reiser MF, & Baur-Melnyk A: Assessment of the internal craniocervical ligaments with a new magnetic resonance imaging sequence: three-dimensional turbo spin echo with variable flip-angle distribution (SPACE). Magn Reson Imaging 27:954960, 2009

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4

    Bowen BC, , Fraser K, , Kochan JP, , Pattany PM, , Green BA, & Quencer RM: Spinal dural arteriovenous fistulas: evaluation with MR angiography. AJNR Am J Neuroradiol 16:20292043, 1995

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5

    Binkert CA, , Kollias SS, & Valavanis A: Spinal cord vascular disease: characterization with fast three-dimensional contrast-enhanced MR angiography. AJNR Am J Neuroradiol 20:17851793, 1999

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 6

    Chen J, & Gailloud P: Safety of spinal angiography: complication rate analysis in 302 diagnostic angiograms. Neurology 77:12351240, 2011

  • 7

    Farb RI, , Kim JK, , Willinsky RA, , Montanera WJ, , terBrugge K, & Derbyshire JA, et al.: Spinal dural arteriovenous fistula localization with a technique of first-pass gadolinium-enhanced MR angiography: initial experience. Radiology 222:843850, 2002

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8

    Forbes G, , Nichols DA, , Jack CR Jr, , Ilstrup DM, , Kispert DB, & Piepgras DG, et al.: Complications of spinal cord arteriography: prospective assessment of risk for diagnostic procedures. Radiology 169:479484, 1988

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9

    Hartmann J, & Rabinstein AA: Can we rule out a spinal arteriovenous fistula using only MRI? Yes, we can. Neurology 79:1516, 2012

  • 10

    Jellema K, , Tijssen CC, & van Gijn J: Spinal dural arteriovenous fistulas: a congestive myelopathy that initially mimics a peripheral nerve disorder. Brain 129:31503164, 2006

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 11

    Kirsch M, , Berg-Dammer E, , Musahl C, , Bäzner H, , Kühne D, & Henkes H: Endovascular management of spinal dural arteriovenous fistulas in 78 patients. Neuroradiology 55:337343, 2013

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12

    Krings T, & Geibprasert S: Spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 30:639648, 2009

  • 13

    Krings T, , Lasjaunias PL, , Hans FJ, , Mull M, , Nijenhuis RJ, & Alvarez H, et al.: Imaging in spinal vascular disease. Neuroimaging Clin N Am 17:5772, 2007

  • 14

    Lindenholz A, , TerBrugge KG, , van Dijk JM, & Farb RI: The accuracy and utility of contrast-enhanced MR angiography for localization of spinal dural arteriovenous fistulas: the Toronto experience. Eur Radiol 24:28852894, 2014

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15

    Luetmer PH, , Lane JI, , Gilbertson JR, , Bernstein MA, , Huston J III, & Atkinson JL: 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. AJNR Am J Neuroradiol 26:711718, 2005

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16

    Morris JM, , Kaufmann TJ, , Campeau NG, , Cloft HJ, & Lanzino G: Volumetric myelographic magnetic resonance imaging to localize difficult-to-find spinal dural arteriovenous fistulas. J Neurosurg Spine 14:398404, 2011

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 17

    Mull M, , Nijenhuis RJ, , Backes WH, , Krings T, , Wilmink JT, & Thron A: Value and limitations of contrast-enhanced MR angiography in spinal arteriovenous malformations and dural arteriovenous fistulas. AJNR Am J Neuroradiol 28:12491258, 2007

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18

    Oda S, , Utsunomiya D, , Hirai T, , Kai Y, , Ohmori Y, & Shigematsu Y, et al.: Comparison of dynamic contrast-enhanced 3T MR and 64-row multidetector CT angiography for the localization of spinal dural arteriovenous fistulas. AJNR Am J Neuroradiol 35:407412, 2014

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19

    Saindane AM, , Boddu SR, , Tong FC, , Dehkharghani S, & Dion JE: Contrast-enhanced time-resolved MRA for pre-angiographic evaluation of suspected spinal dural arterial venous fistulas. J Neurointerv Surg 7:135140, 2015

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20

    Saraf-Lavi E, , Bowen BC, , Quencer RM, , Sklar EML, , Holz A, & Falcone S, et al.: Detection of spinal dural arteriovenous fistulae with MR imaging and contrast-enhanced MR angiography: sensitivity, specificity, and prediction of vertebral level. AJNR Am J Neuroradiol 23:858867, 2002

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21

    Si-jia G, , Meng-wei Z, , Xi-ping L, , Yu-shen Z, , Jing-hong L, & Zhong-hui W, et al.: The clinical application studies of CT spinal angiography with 64-detector row spiral CT in diagnosing spinal vascular malformations. Eur J Radiol 71:2228, 2009

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22

    Toossi S, , Josephson SA, , Hetts SW, , Chin CT, , Kralik S, & Jun P, et al.: Utility of MRI in spinal arteriovenous fistula. Neurology 79:2530, 2012

  • 23

    Yamaguchi S, , Nagayama T, , Eguchi K, , Takeda M, , Arita K, & Kurisu K: Accuracy and pitfalls of multidetector-row computed tomography in detecting spinal dural arteriovenous fistulas. J Neurosurg Spine 12:243248, 2010

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation

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