Value of prominent flow voids without cord edema in the detection of spinal arteriovenous fistulae

Authors

Lea M. Alhilali, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.Follow
Arich R. Reynolds, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.
Saeed Fakhran, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, United States of America.

Document Type

Article

Abstract

PURPOSE: To determine the prevalence of spinal dural arteriovenous fistulae (SDAVF) in patients presenting with prominent vascular flow voids on imaging without other imaging findings suggestive of SDAVF. METHODS: We retrospectively identified patients from January 1, 2005 to March 1, 2012 who underwent spinal angiography for suspected SDAVF with prominent vascular flow voids on prior imaging. We excluded patients with other major spinal pathology or other imaging findings of SDAVF including cord hyperintensity, enhancement, or expansion. We calculated the proportion of patients with positive findings for SDAVF on angiography and evaluated the prevalence of SDAVF for this finding alone and in correlation with clinical findings. RESULTS: 18 patients underwent spinal angiography for prominent flow voids on imaging without other spinal pathology or imaging findings of SDAVF. Three had a SDAVF detected on angiography. The prevalence of SDAVF in this population was low, only 17% (95% CI 6-39%). All of the patients with positive angiography findings had myelopathy, increasing the prevalence to 100% if the additional clinical finding of myelopathy was present. CONCLUSIONS: Prominent flow voids without other imaging findings suggestive of SDAVF is poorly predictive of the presence of a SDAVF, unless myelopathy is present clinically.

Medical Subject Headings

Adolescent; Adult; Aged; Aged, 80 and over; Angiography; Arteriovenous Fistula (complications, diagnosis, diagnostic imaging, physiopathology); Child; Child, Preschool; Dura Mater (diagnostic imaging, physiopathology); Female; Humans; Hydrodynamics; Male; Middle Aged; Retrospective Studies; Spinal Cord (diagnostic imaging, physiopathology); Young Adult

Publication Date

1-1-2014

Publication Title

PloS one

E-ISSN

1932-6203

Volume

9

Issue

6

First Page

e99004

PubMed ID

24905497

Digital Object Identifier (DOI)

10.1371/journal.pone.0099004

Recommended Citation

Alhilali, Lea M.; Reynolds, Arich R.; and Fakhran, Saeed, "Value of prominent flow voids without cord edema in the detection of spinal arteriovenous fistulae" (2014). Neurology. 1287.
https://scholar.barrowneuro.org/neurology/1287