The Use of Magnetic Resonance Imaging in Predicting the Clinical Outcome of Spinal Arteriovenous Fistula.
10.3349/ymj.2015.56.2.397
- Author:
Dong Ah SHIN
1
;
Keun Young PARK
;
Gyu Yeul JI
;
Seong YI
;
Yoon HA
;
Seoung Woo PARK
;
Do Heum YOON
;
Keung Nyun KIM
Author Information
1. Department of Neurosurgery, Yonsei University College of Medicine, Seoul, Korea. knkim@yuhs.ac
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords:
Spine;
dural arteriovenous fistula;
magnetic resonance imaging;
neurologic manifestations
- MeSH:
Adult;
Aged;
Angiography;
Arteriovenous Fistula/*pathology/radiography/*surgery;
Central Nervous System Vascular Malformations/*pathology/radiography/*surgery;
Embolization, Therapeutic/*methods;
Female;
Humans;
*Magnetic Resonance Imaging;
Male;
Middle Aged;
Postoperative Period;
Predictive Value of Tests;
Prognosis;
Retrospective Studies;
Severity of Illness Index;
Spinal Cord/abnormalities/*blood supply/pathology/surgery;
Treatment Outcome
- From:Yonsei Medical Journal
2015;56(2):397-402
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Magnetic resonance imaging (MRI) has been used to screen and follow-up spinal dural arteriovenous fistulae (SDAVF). The purpose of this study was to evaluate the association between MRI findings and neurologic function in SDAVF. This study also investigated clinical features and treatment results of SDAVF. MATERIALS AND METHODS: A total of 15 consecutive patients who underwent embolization or surgery for SDAVF were included. We treated seven (60%) patients with embolization and six (40%) with surgery. We analysed clinical features, MRI findings, treatment results, and neurologic function. Neurologic function was measured by the Aminoff-Logue disability scale (ALS). RESULTS: Patients with longer levels of intramedullary high signal intensity in preoperative T2-weighted images (T2WI) exhibited worse pre- and postoperative ALS scores (r=0.557, p=0.031; r=0.530, p=0.042, Pearson correlation). Preoperative ALS score was significantly correlated with postoperative ALS score (r=0.908, p=0.000, Pearson correlation). The number of levels showing intramedullary high signal intensity in T2WI decreased significantly postoperatively (5.2+/-3.1 vs. 1.0+/-1.4, p=0.001, Wilcoxon ranked test). CONCLUSION: The number of involved levels of high signal intensity in preoperative T2WI is useful for predicting pre- and postoperative neurologic function in SDAVF.
