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Spinal vascular malformations: MR angiography after treatment
M Mascalchi1, G Ferrito, N Quilici
1Department of Clinical Pathophysiology, Section of Radiodiagnostics, University of Florence, Viale Morgagni 85, 50134 Florence, Italy.
Radiology
|April 27, 2001
Summary
Magnetic resonance (MR) angiography is effective for assessing spinal vascular malformation treatment outcomes. It accurately detects residual or recurrent flow, indicating malformation patency, outperforming MR imaging in these assessments.
Area of Science:
- Neurology
- Radiology
- Vascular Surgery
Background:
- Spinal vascular malformations (SVMs) require effective therapeutic monitoring.
- Accurate assessment of treatment efficacy is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the role of magnetic resonance (MR) angiography in assessing the outcomes of spinal vascular malformation therapies.
- To compare the sensitivity of MR angiography versus MR imaging in detecting treatment failure.
Main Methods:
- Retrospective analysis of 34 patients with SVMs (dural AV fistulas, perimedullary AV fistulas, intramedullary AVMs).
- Patients underwent MR angiography and MR imaging before and after endovascular or surgical treatment.
- Arteriography was used as a gold standard for confirmation in select cases.
Main Results:
- MR angiography detected residual flow in 7/30 dural fistulas post-embolization, confirmed by arteriography.
- Long-lasting flow disappearance was seen in 22/30 dural fistulas.
- MR imaging showed varied normalization of spinal cord volume and signal intensity.
- MR angiography identified recurrent flow in one patient, indicating treatment failure.
Conclusions:
- MR angiography is more sensitive than MR imaging for detecting residual or recurrent flow in peri- or intramedullary vessels.
- This sensitivity indicates the patency of spinal vascular malformations post-treatment.
- MR angiography is a valuable tool for monitoring SVM therapy effectiveness.