Congestive Myelopathy Due to Cervical Perimedullary Arteriovenous Fistula Evaluated by Apparent Diffusion Coefficient Values-Case Report-

Inoue, Tomoo; Takahashi, Toshiyuki; Shimizu, Hiroaki; Matsumoto, Yasushi; Takahashi, Akira; Tominaga, Teiji

doi:10.2176/nmc.46.559

Cited by 16 publications

(4 citation statements)

References 13 publications

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“…Our results concerning myelopathy secondary to SDAVF confirm an increased diffusion already described in the literature stemming from intramedullary vasogenic oedema formation after venous congestion [39]. The radiological differentiation between SDAVF and other myelopathies associated with increased diffusion are not particularly difficult, however.…”

Section: Discussionsupporting

confidence: 87%

Diffusion-weighted imaging in noncompressive myelopathies: a 33-patient prospective study

et al. 2010

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Diffusion-weighted imaging (DWI) is frequently used to differentiate cerebral lesions. The aim of our study was to evaluate the diagnostic value of DWI and the measurement of the apparent diffusion coefficient (ADC) in noncompressive myelopathy explorations. Thirty-three patients presenting a spinal cord syndrome due to a noncompressive myelopathy underwent spinal cord MRI between September 2005 and November 2008. For each patient, the ADC was calculated in the pathological spinal cord. ADC values were also measured in the healthy spinal cord of ten control subjects. Statistical analysis was based on the Student's t test. Twenty-one patients presented an inflammatory myelopathy: Nine patients presented multiple sclerosis, three patients presented a parainfectious myelopathy, two patients acute disseminated encephalomyelitis, one patient neuromyelitis optica, one patient systemic lupus erythematosus, and five patients a myelopathy of unknown aetiology. Six patients presented a spinal cord infarction. ADC values were significantly lower in spinal cord infarct (mean ADC = 0.81 +/- 0.08 x 10(-3) mm(2)/s) than in inflammatory spinal cord lesions (mean ADC = 1.37 +/- 0.23 x 10(-3) mm(2)/s) and in healthy control spinal cord (mean ADC = 0.93 +/- 0.07 x 10(-3) mm(2)/s). These results are important to differentiate ischaemic from inflammatory myelopathies, especially at the acute phase when clinical presentation and extensive work-up are not able to show an aetiologic diagnosis. Although these results are similar to those described in cerebral explorations, ADC measurements remain technically limited for the moment.

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Section: Discussionsupporting

confidence: 87%

Diffusion-weighted imaging in noncompressive myelopathies: a 33-patient prospective study

et al. 2010

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“…Diffusion sequences have demonstrated their use in the detection of ischemia of the brain (12), and hence might be used in the diagnosis of similar lesions of the cord. Increasingly used in exploration of myelitis and to obtain details on tissue characterization and integrity (12), these sequences can give information about the nature of the edema due to SCAVSs (vasogenic or cytotoxic) (13). Diffusion WI can also aid in the differential diagnosis between ischemia and posttherapeutic edematous reaction.…”

Section: Nonvascular Sequencesmentioning

confidence: 99%

MRI and MRA of spinal cord arteriovenous shunts

Condette–Auliac

Boulin

Roccatagliata

et al. 2014

Magnetic Resonance Imaging

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The purpose of this review is to describe the diagnostic criteria for spinal cord arteriovenous shunts (SCAVSs) when using magnetic resonance imaging (MRI) and magnetic resonance angiography (MRA), and to discuss the extent to which the different MRI and MRA sequences and technical parameters provide the information that is required to diagnose these lesions properly. SCAVSs are divided into four groups according to location (paraspinal, epidural, dural, or intradural) and type (fistula or nidus); each type of lesion is described. SCAVSs are responsible for neurological symptoms due to spinal cord or nerve root involvement. MRI is usually the first examination performed when a spinal cord lesion is suspected. Recognition of the image characteristics of vascular lesions is mandatory if useful sequences are to be performed-especially MRA sequences. Because the treatment of SCAVSs relies mainly on endovascular therapies, MRI and MRA help with the planning of the angiographic procedure. We explain the choice of MRA sequences and parameters, the advantages and pitfalls to be aware of in order to obtain the best visualization, and the analysis of each lesion.

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“…Therefore, careful diagnoses is essential because some venous infarctions occasionally show a ring-like enhancement that mimics a tumor 1 , or flow voids as collateral anastomoses develop. Cerebral infarctions or bleeding, leptomeningeal or medullary vascular enhancements, and the ADC map are useful to estimate the prognosis of d-AVF 2,3 . An d-AVF on an atypical location, without communication to sinuses, and draining into cortical veins should belong in Borden's classification type III.…”

Section: Case 2: a 75-year-old Womanmentioning

confidence: 99%

Two Cases of a Dural Arteriovenous Fistula Mimicking a Brain Tumor

Ishihara

Okawara³

et al. 2009

Interv Neuroradiol

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Dural arteriovenous fistula (d-AVF) is relatively rare. Some cases of atypical locations are often difficult to distinguish from other vascular disorders or tumors because those d-AVFs show various onsets, such as subcortical bleeding and venous infarctions. We encountered two cases of d-AVF with severe brain edema that took adequate time to distinguish from brain tumors. A 68-year-old man visited his local physician complaining of dizziness. He was diagnosed with a cerebral infarction due to the presence of an abnormal cerebellar signal on magnetic resonance imaging (MRI) and was treated by drip infusion. However, he did not recover and was admitted to our hospital with suspicion of a brain tumor. A 75-year-old woman with an onset of progressive dementia and gait disturbance showed severe edema of the right-front temporal lobe on MRI. Both these cases were examined by single photon emission computed tomography or positron emission tomography and were scheduled for craniotomy and biopsy based on the diagnosis of brain tumor. We performed pre-operative angiography and found d-AVFs. We embolized the d-AVFs with liquid material and both patients recovered well. Brain edema from d-AVF or a tumor can be distinguished by carefully reading the MRI with findings such as the distribution of the edemas, differences on diffusion-weighted images, and contrast-enhanced images. Therefore, it is important to provide initial accurate diagnoses to prevent patient mistrust and irreversible disease conditions.

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Congestive Myelopathy Due to Cervical Perimedullary Arteriovenous Fistula Evaluated by Apparent Diffusion Coefficient Values-Case Report-

Cited by 16 publications

References 13 publications

Diffusion-weighted imaging in noncompressive myelopathies: a 33-patient prospective study

Diffusion-weighted imaging in noncompressive myelopathies: a 33-patient prospective study

MRI and MRA of spinal cord arteriovenous shunts

Two Cases of a Dural Arteriovenous Fistula Mimicking a Brain Tumor

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