Routine magnetic resonance imaging characteristics of dural arteriovenous fistulas
10.3760/cma.j.cn113694-20240812-00547
- VernacularTitle:硬脑膜动静脉瘘常规磁共振成像特征分析
- Author:
Xiaodong WU
1
;
Jinfeng ZHAN
;
Jiufa CUI
;
Cheng DONG
;
Xuejun LIU
;
Ruizhi ZHOU
;
Song LIU
Author Information
1. 青岛大学附属医院器官移植中心，青岛266000
- Publication Type:Journal Article
- Keywords:
Arteriovenous fistula;
Meninges;
Magnetic resonance imaging;
Magnetic resonance angiography;
Diagnosis, differential
- From:
Chinese Journal of Neurology
2025;58(5):513-519
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the diagnostic value of routine magnetic resonance imaging (MRI) findings for early detection of dural arteriovenous fistulas (DAVF).Methods:A retrospective collection of 53 patients with DAVF confirmed by digital subtraction angiography (DSA) at the Affiliated Hospital of Qingdao University from September 2018 to June 2023 was conducted. All patients underwent routine non-enhanced and enhanced MRI scans before treatment, with 30 patients also receiving magnetic resonance angiography (MRA) examination. Medical records were reviewed, and basic patient information, clinical symptoms, and imaging markers [pial venous engorgement (PVE), cerebral hemorrhage, subarachnoid hemorrhage, vasogenic edema, venous infarction, medullary veins engorgement (MVE), parenchymal enhancement, encephalopathy mimics] were recorded. The Cognard grading was carried out in accordance with the manifestations shown by DSA.Results:Seventy-seven percent (41/53) of patients exhibited PVE on the brain surface, with 95% (39/41) of these cases showing localized PVE on one hemisphere or even within a single brain lobe. Approximately 64% (34/53) of these PVEs were detectable on conventional T 2-weighted imaging. Among the 30 patients who underwent MRA, only 50% (15/30) showed evidence of PVE on both T 2WI and MRA, while an additional 23% (7/30) had PVE only on MRA. About 38% (20/53) of patients presented with isolated vasogenic edema, with 70% (14/20) of these cases demonstrating PVE on T 2WI. Twenty-six percent (14/53) of patients had intracranial hemorrhage, and 11 of these patients demonstrated positive signs of PVE. Parenchymal enhancement was primarily observed in subarachnoid structures in 11% (6/53) of patients, with 5/6 showing PVE on the brain surface or spinal cord surface. Venous infarction (4%, 2/53) and MVE (4%, 2/53) were more commonly seen in high Cognard grade DAVF, whereas encephalopathy mimics (4%, 2/53) were frequently encountered in low Cognard grade DAVF. Conclusions:PVE on the brain surface is a direct sign for the diagnosis of DAVF on routine MRI, yet it is often subtle. Familiarity with common indirect signs is of great importance for the early diagnosis of DAVF.
