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ObjectivesTo examine the utility of standardised volumetric spinal cord measurement as an indicator of successful disconnection of a Type 1 spinal dural arteriovenous fistula.DesignRetrospective analysis at a tertiary neuroscience centre.SubjectsPatients with symptomatic Type 1 spinal dAVFs presenting to the senior author and neurovascular MDT (June 2009 – December 2017). Inclusion based on availability of appropriate cross-sectional imaging. DAVFs arising below T12 excluded: 18 patients with a total 19 dAVFs identified.MethodsType 1 fistulation demonstrated on TRICKS MR angiography and spinal catheter angiography. Sagittal volumes evaluated using Horos (Purview, Annapolis, USA) and wireframe models created. Measurement arbitrarily standardised at ±2 levels from the origin of the fistulous draining vein. Pre- and post-operative clinical outcomes assessed using the Aminoff-Logue Scale. Wilcoxon test employed for between-group comparisons and Spearman’s rank test for clinico-radiological correlation (Prism 7, GraphPad Software, Inc. California).ResultsCord volumes reduced by a mean of 0.854 cm3 (p=0.0181; 95% CI=−1.55,–0.16; SD=1.44). Volume change was not related to gait (r=0.037, p=0.8812, 95% CI=−0.44, 0.49) or micturition scores (r=−0.24, p=0.3165, 95% CI=−0.64, 0.25).ConclusionsSurgical disconnection of type 1 dAVF resulted in a reduction in spinal cord volume. This was not predictive of change in clinical indices in this small series but perhaps merits investigation of this as a surrogate marker in a larger series.

margin. R1 resection are defined if resection margin is less than 1mm. We used pathology report as a "gold standard" for estimation of intraoperative assessment but kappa and Mc Nemar test also used for statistical analysis of agreement. Results: There were included 80 patients,44(55%) male and 36(45%) women in the study 60.4AE9.50 years was average age. Primary tumour was located in 68 (85%) cases on left side of colon. We analyzed 208 liver specimens. In 155 (74.5%) cases there were agreement between surgical and pathological assessment clear margins (R0), in 16 (20.0%) cases both of them decided that it was R1 and 3 (1.44%) times R2 resection margins (positive margins). In 34 (16.3%) cases were disagreement because 25 (12.0%) times surgeon thought that margin was R0, and pathologist found R1, 8 (3.8%) times surgeon thought that was R1, and pathologist found that is R0, and 1 (0.5%) time surgeon's R2 was pathological R1. From this Results we concluded that intra-operative assessment of resection margin had sensitivity 45.65 % and specificity 95.06%. Positive predictive value was 74.2% and negative predictive value was 86.0%. Kappa K=0.466. There were significantly more positive margin by pathology examination 46 (22.1%) vs 29 (13.9%), p=0.008. Conclusion:Our Results suggest that intra-operative assessment resection margin have moderate agreement with pathological assessment as "gold standard". Pathology examination detect significantly more postitive resection margin.