התמחויות

Two-Part Imaging Technique Best For Spinal Dural Fistulae

06/12/2002
By Anne MacLennan

Adding angiographic to standard magnetic resonance imaging of the spine may improve sensitivity in detection of spinal dural fistulae.

The principal benefit of magnetic resonance (MR) angiography is in the improved localisation of the vertebral level of the fistula.

 This potentially expedites the subsequent digital subtraction angiography. These are the findings of a study from the University of Miami School of Medicine, Miami, Florida and the University of California, Davis, Davis, California.

This is the first study to show sensitivity, specificity, and accuracy of MR imaging alone compared with MR imaging plus MR angiography in determining presence of spinal dural arteriovenous fistulae (AVF).

As well as comparing the two techniques, Efrat Saraf-Lavi and colleagues sought to establish the accuracy of MR angiography in predicting fistula level. There were 20 patients with surgically proven dural AVF (diagnosed with radiographic digital subtraction angiography) and 11 control patients who had normal digital subtraction angiography findings in this study. All of them underwent routine MR imaging plus 3D contrast-enhanced MR angiography of the spine.

Three neuroradiologists blinded to the final diagnoses then reviewed the images in two stages: stage I was MR images only and stage II, MR images plus angiograms.

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